Officer: Undertakings X 3

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 is a 3 Years Fixed Term Contract.

Purpose of the Job: To administer the undertakings in line with Section 17(4)(a) of the RAF Act 56 of 1996 as amended.

Key Performance Areas

Handle Claims

• Interpret the settlement, the undertaking and any limitations to determine the Funds liability for future costs to be incurred.

• Scrutinize past medical expenses to determine the Funds liability for future costs to be incurred.
• Identify any differences between the final settlements and re-draft the undertaking to reflect the correct liability.
• Take cognisance of all expert reports, of internal and external origin, to determine the following:

• • The nexus between the costs incurred and the accident.
  • The reasonability of the costs by comparing the costs incurred with the claimants personal circumstances and needs
  • Communicate with experts where there is uncertainty i.r.o. costs incurred.
  • Report any discrepancies to Senior Officer.

• Pre-authorise costs still to be incurred in terms of the undertaking within the mandate and in line with the medical and legal assessment.
• Recommend or approve payment of the costs as per the mandate; or repudiate the costs; or request more information or refer for medical intervention.
• Refer cases to field Case Managers for further investigation
• Determine the need for home visits and attend when required.
• Determine the need for the appointment of experts to do further assessments.
• Approve other officers payments on MIS which includes checking for duplicates and if the correct payee is being paid.

Update claims records

• Correct/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.

Manage Correspondence

• Draft legal correspondence to all external stakeholders.

Attend to queries

• Attend to queries from internal and external stakeholders pertaining to the undertaking including the following:
• Liability of the Fund in terms of the undertaking.
• How to submit a claim.
• Status/progress made on the claims already submitted.
• General enquiries.
•  Give advice to stakeholders on legal issues pertaining to undertakings.

Manage Litigation

• Receive & record all litigation processes served in terms of the Undertaking.
• Evaluate the documents, consider the Funds legal position with regards to the process.
• Arrange for the matter to be held over, if necessary, alternatively.
• Appoint an attorney for the Fund to defend the matter.
• Refer the matter for assessment to determine the Funds liability.
• Negotiate settlement with the attorney, alternatively, consider the opinions from the attorney and give clear instruction to the Funds attorneys to reach settlement.
• Adhere to the time limits to prevent any wasted costs
• Attend to opinions from attorneys to ensure that the Fund is ready for trial when due.
• Report any risk to the senior to prevent any prejudice to the Fund.
• Arrange for interim disbursements to be attended to appropriately at Legal costs.
• Give proper instructions for settlement payments or payments in terms of court orders to prevent any unnecessary interest to be added.
• Arrange for the bill for costs to be referred to Legal costs to attend to and follow up on payment thereof.
• Report any actions from the Funds attorneys which is not in line with the Funds policies to the senior.

Compile Statistics

• Keep daily stats of activities on Undertakings and related matters.

• Submit daily stats and monthly stats as required by Management.
• Keep record of statistics.

Keep claims records

• Maintain record of all allocated matters.
• Maintain record of litigated matters.
• Maintain and apply a diary system used to pend matters to be followed up.

• Scrutinize incoming correspondence and maintain proper record thereof.
• Maintain proper record of files requested and returned to the I/S, referred to Medical and/or Administration cell.
• Keep record of private telephone calls and submit accurate telephone accounts on a monthly basis

Qualifications 

• NQF 7 (Bachelor’s Degree OR Advanced Diploma) related qualification to discipline.

Experience 

• Relevant 3 years’ experience in the claims environment

Behavioural Competencies

• Personal mastery
• Emotional wisdom
• Ethics and governance
• Customer orientation and customer focus

Technical Competencies

• Computer literacy.
• Advanced Third Party Knowledge.
• Negotiating skills.
• Administration skills.
• Communication skills.
• Writing skills.
• Assertiveness.
• Analytical thinking.

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.