Officer: Claims Investigation

The Road Accident Fund’s mission is to provide appropriate cover to all road users within the borders of South Africa; to rehabilitate and compensate persons injured as a result of motor vehicle accidents in a timely and caring manner; and to actively promote safe use of our roads.

NB: This a 12 Months Fixed Term Contract

Purpose of the Job: The Officer Claims Investigations is responsible for effectively and efficiently providing investigative support services for claims lodged against the Road Accident Fund (RAF)

Key Performance Areas

Investigation and assessment of claims lodged.

• Trace insured driver / witnesses to consult and obtain statements and docket.
• Ensure that a proper sketch plan of an accident scene is drawn as part of the investigation and assessment process.
• Ensure that clear photographs of an accident scene, faces of the people interviewed, damaged vehicles and injuries to a person is taken as part of the investigation and assessment process.
• Obtain / and verify existing affidavits from different parties (e.g. claimants, witnesses, employers, etc.).
•  Identify possible fraud and corruption and escalate to Forensic Investigation Department (FID).
• Testify in court cases when claimant is guilty and accused of fraud.
• Provide assistance in ensuring witness presence at court.

Administrative support.

• Validate supporting documents (e.g. employment details, paternity/maternity details, SARS documents, etc.) for all related quantum investigations.
• Verify details of the claimant and those injured in an accident through Natis and Cross Check systems (e.g. ID no, contact numbers, address/S, employment details etc.).
• Verify the details of the secondary vehicle/s involved in the accident to determine the owner/s.
• Quality check the supporting documents from the stakeholders to determine the validity of the logged claim.
• Validate loss of earnings.
• Provide progress reports as per the internal service level agreement.

Document and records Management.

• Monitor and maintain an effective filing system.
• Ensure that files are correctly categorised and stored to ensure a smooth retrieval of documents.
• Administer the records management and filing processes in line with the RAF filing plan.
• Ensure confidentiality of all documents under control and that correspondence from the department office reaches intended recipients.
• Perform File Retrieval in Archive Services.

Stakeholder Management.

•  Provide advice to different parties (e.g. claimants, witnesses, employers, etc.)
•  Handle any assessments associated complaints.
•  Maintain relationships with internal and external stakeholders.

Qualifications

• NQF 7 (Bachelor’s Degree/Advanced Diploma) related qualification to discipline.
• Driver’s License
• Completed training as an investigator will be an added advantage.
• Being a certified fraud examiner will be an added advantage.

Experience

• Relevant 3 years’ experience in a similar environment.
• Experience in merit and quantum investigations will be an added advantage.

Competencies

Behavioural:

• Personal mastery.
• Emotional Wisdom.
• Ethics and Governance.
• Customer orientation and customer focus.

Technical:

• Knowledge of Natis and cross Check systems.
• Ability to obtain appropriate affidavits.
• Report writing skills.
• Computer literacy (MS office and SAP).
• Attention to detail and accuracy.
• General Administration and document management.

Road Accident Fund Values

• Integrity
• Compassion
• Accountability
• Respect
• Excellence
• Empathy

NB: “RAF offers Total Employment Cost packages with no additional contributions from the Employer, successful candidates are required to structure their packages in a manner that will suit their needs”

The Road Accident Fund subscribes to the principles of employment equity and preference will be given to People with Disabilities.

Applicants who have not received any correspondence from us within six weeks from the closing date can consider themselves unsuccessful

Security Vetting shall be conducted on all prospective employees

It is the applicants’ responsibility to have foreign qualification evaluated by the South African Qualification Authority (SAQA) and to provide proof of such evaluation.