Claims Consultant at Sohva - Hollard (2022-03 – Present)
Claims Consultant specializing in workflow optimization, complex claims investigation, and customer service excellence.
- Accelerating claims resolution efficiency by streamlining workflow processes and introducing best practices, resulting in a 30% reduction in turnaround time and consistently outperforming resolution benchmarks.
- Investigating complex claims thoroughly, analyzing documentation against policy terms and underwriting rules to ensure full compliance while identifying coverage limitations, contributing to accurate and fair claims decisions.
- Delivering empathetic, high-impact customer support by keeping policyholders consistently informed, enhancing client trust and contributing to a higher customer satisfaction score across service interactions.
- Resolving high-stakes, escalated cases through advanced negotiation techniques and technical insurance knowledge, often recovering disputed claim value while maintaining policyholder relationships.
- Detecting potential fraud by conducting in-depth document and statement analysis, helping to safeguard Hollard's financial integrity and support ethical claim settlement.
- Researching incident reports and policy data proactively, providing timely, tailored solutions to client concerns, while maintaining detailed records to ensure regulatory compliance and case traceability.
Claims Consultant at Sanlam Indie (2021-01 – 2022-02)
Claims Consultant managing high-volume claims processing with focus on customer service and regulatory compliance.
- Achieving consistent monthly performance above target by processing high volumes of claims with precision and speed, contributing to a departmental benchmark for accuracy and turnaround time.
- Resolving customer queries within strict SLA timelines, ensuring transparent communication at every touchpoint and directly contributing to a noticeable increase in customer satisfaction and retention metrics.
- Educating policyholders on Sanlam Indie's insurance offerings and claim procedures, empowering clients to make informed decisions and reducing follow-up inquiries through clear, concise guidance.
- Coordinating with underwriting, finance, and legal departments to fast-track complex, disputed, or high-risk claims, demonstrating cross-functional collaboration and accelerating resolution time.
- Managing and expanding assigned policyholder portfolios, proactively monitoring accounts to ensure claim eligibility, policy compliance, and ongoing customer engagement.
- Implementing service excellence strategies by identifying recurring claim trends and recommending process improvements, helping Sanlam Indie streamline workflows and enhance client service delivery.
Outbound Sales Consultant at Sanlam Indie (2020-05 – 2021-01)
Outbound Sales Consultant driving high-volume sales campaigns for short-term and long-term insurance products.
- Driving high-volume outbound sales campaigns by proactively contacting prospective clients to promote Sanlam Indie's short-term and long-term insurance products, consistently surpassing daily and monthly targets and earning recognition for top-tier performance.
- Delivering persuasive and compliant product presentations by thoroughly understanding customer needs, aligning offerings accordingly, and adhering strictly to FAIS and TCF regulations.
- Building rapport and trust with diverse clients through clear communication and empathy, leading to increased policy uptake and reduced customer objections, while cultivating long-term loyalty to the Sanlam Indie brand.
- Managing end-to-end policy onboarding by collecting client information, verifying eligibility, explaining policy terms in detail, and ensuring seamless documentation processing, all while maintaining a high first-time accuracy rate.
- Resolving objections and handling queries with professionalism, converting hesitations into successful sales by applying objection-handling techniques.
- Contributing to overall team success by consistently mentoring new team members, sharing closing techniques, and actively participating in performance improvement initiatives that enhanced overall departmental KPIs.
Claims Consultant at Telesure Investment Holdings (2017-01 – 2020-04)
Claims Consultant implementing SOPs and managing high-volume caseloads with focus on complex claims resolution.
- Implementing new Standard Operating Procedures (SOPs) for early-stage claims assessments at Telesure Investment Holdings, significantly improving departmental efficiency and reducing average handling time for initial claim evaluations.
- Managing a high-volume caseload of over 50 claims weekly with precision and consistency, ensuring compliance with internal standards and maintaining over 98% accuracy in claim evaluations.
- Collaborating closely with legal, risk, and underwriting departments on high-value and complex claims, facilitating swift, informed decisions and reducing liability exposure for the company.
- Resolving intricate claims issues by applying in-depth knowledge of policy terms and regulatory frameworks, successfully closing contentious cases while minimizing escalations and maintaining policyholder trust.
- Enhancing claims processing workflows by streamlining communication and documentation practices, which led to a measurable boost in turnaround time and an overall increase in team productivity.
- Proactively updating policyholders and brokers on claim statuses, outcomes, and next steps, resulting in improved transparency and a noticeable drop in complaint ratios through trust-building, consistent follow-ups.
- Delivering client-centric service excellence by actively listening to customer concerns, offering tailored support, and maintaining an empathetic yet professional approach—ultimately boosting client satisfaction scores and retention.
