Key Performance Areas<\/p>\n
Handle Claims<\/p>\n
\tInterpret the settlement, the undertaking and any limitations to determine the Funds liability for future costs to be incurred.
\n\tScrutinize past medical expenses to determine the Funds liability for future costs to be incurred.
\n\tIdentify any differences between the final settlements and re-draft the undertaking to reflect the correct liability.
\n\tTake cognisance of all expert reports, of internal and external origin, to determine the following:
\n\tThe nexus between the costs incurred and the accident.
\n\tThe reasonability of the costs by comparing the costs incurred with the claimants\u2019 personal circumstances and needs
\n\tCommunicate with experts where there is uncertainty i.r.o. costs incurred.
\n\tReport any discrepancies to Senior Officer
\n\tPre-authorise costs still to be incurred in terms of the undertaking within the mandate and in line with the medical and legal assessment.
\n\tRecommend or approve payment of the costs as per the mandate; or repudiate the costs; or request more information or refer for medical intervention.
\n\tRefer cases to field Case Managers for further investigation
\n\tDetermine the need for home visits and attend when required.
\n\tDetermine the need for the appointment of experts to do further assessments.
\n\tApprove other officers\u2019 payments on MIS which includes checking for duplicates and if the correct payee is being paid.<\/p>\n
Update claims records \u00a0<\/p>\n
\tCorrect\/update any change in the settlement details on the undertaking system to ensure that the liability of the Fund is accurately reflected on the system.<\/p>\n
Manage Correspondence<\/p>\n
\tDraft legal correspondence to all external stakeholders.<\/p>\n
Attend to queries<\/p>\n
\tAttend to queries from internal and external stakeholders pertaining to the undertaking including the following:
\n\tLiability of the Fund in terms of the undertaking.
\n\tHow to submit a claim.
\n\tStatus\/progress made on the claims already submitted.
\n\tGeneral enquiries.
\n\tGive advice to stakeholders on legal issues pertaining to undertakings.<\/p>\n
Manage Litigation<\/p>\n
\tReceive & record all litigation processes served in terms of the Undertaking.
\n\t\u00a0Evaluate the documents, consider the Funds legal position with regards to the process.
\n\tArrange for the matter to be held over, if necessary, alternatively.
\n\tAppoint an attorney for the Fund to defend the matter.
\n\tRefer the matter for assessment to determine the Funds liability.
\n\tNegotiate settlement with the attorney, alternatively, consider the opinions from the attorney and give clear instruction to the Funds attorneys to reach settlement.
\n\tAdhere to the time limits to prevent any wasted costs
\n\tAttend to opinions from attorneys to ensure that the Fund is ready for trial when due.
\n\tReport any risk to the senior to prevent any prejudice to the Fund.
\n\tArrange for interim disbursements to be attended to appropriately at Legal costs.
\n\tGive proper instructions for settlement payments or payments in terms of court orders to prevent any unnecessary interest to be added.
\n\tArrange for the bill for costs to be referred to Legal costs to attend to and follow up on payment thereof.
\n\tReport any actions from the Funds attorneys which is not in line with the Funds policies to the senior.<\/p>\n
Compile Statistics<\/p>\n
\tKeep daily stats of activities on Undertakings and related matters.
\n\tSubmit daily stats and monthly stats as required by Management.
\n\tKeep record of statistics.<\/p>\n
Keep claims records<\/p>\n
\tMaintain the record of all allocated matters.
\n\tMaintain record of litigated matters.
\n\tMaintain and apply a diary system used to pend matters to be followed up.
\n\tScrutinize incoming correspondence and maintain proper record thereof.
\n\tMaintain proper record of files requested and returned to the I\/S, referred to Medical and\/or Administration cell.
\n\tKeep record of private telephone calls and submit accurate telephone accounts monthly basis.<\/p>\n
Qualifications and Experience<\/p>\n
\t\u00a0NQF 7(bachelor\u2019s degree OR Advanced Diploma) related qualification to discipline.
\n\tRelevant 3 years\u2019 experience in the claim\u2019s environment.<\/p>\n
go to method of application \u00bb<\/p>\n
Apply via company website ( http:\/\/www.raf.co.za ) or<\/p>\n
<\/p>\n","protected":false},"author":2,"featured_media":0,"template":"","meta":{"_promoted":"","_job_location":"","_application":"","_company_name":"Road Accident Fund","_company_website":"http:\/\/www.raf.co.za","_company_tagline":"The Road Accident Fund is a state insurer established by statute, it provides insurance cover to all drivers of motor vehicles in South Africa in respect of liability incurred or damage caused as a result of a traffic collision. Liability incurred in relation to property damage (such as damage to ve... read morehicles, buildings, vehicle contents) is excluded from cover.","_company_twitter":"","_company_video":"","_filled":0,"_featured":0,"_remote_position":0,"_job_salary":"","_job_salary_currency":"","_job_salary_unit":""},"job_listing_region":[16],"job-types":[18],"class_list":["post-19627","job_listing","type-job_listing","status-expired","hentry","job_listing_region-kwazulu-natal","job-type-contract"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/jobs.dataaxisnode.com\/southafrica\/wp-json\/wp\/v2\/job-listings\/19627","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jobs.dataaxisnode.com\/southafrica\/wp-json\/wp\/v2\/job-listings"}],"about":[{"href":"https:\/\/jobs.dataaxisnode.com\/southafrica\/wp-json\/wp\/v2\/types\/job_listing"}],"author":[{"embeddable":true,"href":"https:\/\/jobs.dataaxisnode.com\/southafrica\/wp-json\/wp\/v2\/users\/2"}],"wp:attachment":[{"href":"https:\/\/jobs.dataaxisnode.com\/southafrica\/wp-json\/wp\/v2\/media?parent=19627"}],"wp:term":[{"taxonomy":"job_listing_region","embeddable":true,"href":"https:\/\/jobs.dataaxisnode.com\/southafrica\/wp-json\/wp\/v2\/job_listing_region?post=19627"},{"taxonomy":"job_listing_type","embeddable":true,"href":"https:\/\/jobs.dataaxisnode.com\/southafrica\/wp-json\/wp\/v2\/job-types?post=19627"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}