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ROAD ACCIDENT FUND (RAF)
 
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 the safe use of our roads.
 
The Organisation requires the services of a qualified individual at its East London Regional Office for the position of:
 
THIS IS AN INTERNAL AND EXTERNAL ADVERTISEMENT
 
OFFICER REPRESENTED CLAIMS: T.A.S.K GRADE 10
ORC21052021ELN
LOCATION: East London
CLOSING DATE & TIME: 6/1/2021 11:55 PM
 
Purpose of the Job: To provide claims handling which ensures prompt and fair settlement and finalisation of claims by applying the relevant legal and third party principles.
 
 
Key Performance Areas
Estimate and update value of loss.
  • Review and assess documentation of new files.
  • Determine and request further additional documentation needed.
  • Scrutinise all claims documentation (e.g. Payslip, medico legal reports, hospital records etc.).
  • Should the information be questionable or the possibility of fraud is detected refer the matter to forensics.
  • Estimate quantum /quantity of claims.
     
To acquire expert advice from medical experts, assessors and actuaries.
  • Review and assess the merits of the matter should the attorney not be willing to accept the decision made by the merits department.
  • Pre-empting the appointments of experts.
  • Instruct the relevant experts to determine the seriousness of the injuries sustained e.g. orthopaedic surgeon, occupational therapists, actuary, industrial psychologists.
  • Being pro-active and contacting plaintiff to discuss matters agreeing on experts to save costs.
  • If no experts are required, quantify the claims.

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To prepare a strategic assessment in conjunction with the expert advice and make decisions regarding the seriousness of the injury and quantify benefits.
  • If no expert is required, prepare the offer.
  • Interpret and apply content of medico legal reports, summarise and interpolate same in relation to other reports and then apply same assessment of the matter.
  • Prepare a loss of earning calculations, using the information received as well as the actuarial calculation where it was necessary to appoint one.
  • Determine contingency deductions to be applied.
  • Interpretation and determining the applicability of the CAP under the Amendment Act.
  • Assess the funeral account and award benefit in terms of the RAF Act.
  • Assess the documentation pertaining to loss of support and determining whether the duty to support existed.

 
Quantify benefits and prepare offer.
  • Consider experts reports particularly actuarial calculations.
  • Consider any prior payments/interim payments/WCC/social grants.
  • Review all bills from the hospital and doctors to be included in the offer.
  • Review appropriate case law and book of quantum to determine the amount awarded for general damages.
  • Knowledge of rules of collateral and accelerated benefits.
  • Factors in contingencies also consider merits allocated.
  • Discuss costs to be awarded with senior considering the capital amounts.
  • Review and evaluate all available information to quantify the claims in order to formulate and offer.
  • Should we no offer general damages and this become a dispute then we offer the matter to the tribunal for adjudication on the seriousness of the injury.
  • Obtain approval in terms of delegations and send out offer.
  • Attend and prepare block settlement upon request from attorneys to discuss offer.
  • If accepted request payment and ensure same is done timeously to avoid execution of writs.
  • Prior to loading an offer of settlement or court order check whether the attorney details are correct on the system, to ensure the correct attorneys firm receive the offer or capital payment.
  • Upon payment ascertain whether file can be finalized.
  • If not accepted revise the offer using the additional documentation sent to us by plaintiff to substantiate the request for a revised offer.
  • If summons served, instruct panel attorney according or refer matter to litigation.
 
Liaise with WCC or employer individually liable.
  • Send correspondence to WCC/EIL/SASSA to establish whether they have effected any awards/payments.
  • Factor the final award into award into the calculation of the benefits.
 
Evaluate interim payment request.
  • Consider any prior awards by the WCC/EIL/SASSA.
  • Calculate the loss which should be paid as an interim payment.
  • Initiate payment if applicable.
  • Facilitate payment upon acceptance of offer.
  • Revise offer in consultation with Attorney.
 
Litigation management. Instructing and liaising with Attorneys and Advocates.
  • Give instruction to panel attorneys on:

    - Issues on plea

    - Issues on merits

    - Issues on quantum

    - Agreement of experts, where applicable.
  • Diarise the file continuously provides instructions to ensure that all parties are aware of the claims.
  • Confer with panel attorneys legal counsel on the trial and receive request for approval in terms of the delegation of authority.
  • Ensure that the Panel attorney abide by the SLA.
  • Preparing strategic assessments to ensure a matter is trial ready using the appropriate case law as well as abiding by the court rules.
  • Conveying instructions to defend, settle or tender to panel attorneys and advocates vial mail, telephone or email.
  • Being prepared for emergency situation with the pre-trial and trials when he learns about same on the day of or day before trial.
  • Attempting to settle the matter before trial to curtail legal costs.
  • On receipt of court order execute payment within the required time frame to avoid wits as well as to avoid fruitless and wasteful expenditure in relations to the legal costs of panel and plaintiff attorney.
 
Prepare executive summaries exceeding R900 000.
  • In matters where an executive summary is required officers to speedily prepare same for approval by the necessary management.
  • Being skilled to prepare same on a daily basis and for any head of damage.
  • Ensure the summary is concise, accurate and comprehensive and contains all the relevant information.
 
 
Qualifications & Experience
  • NQF 7(Bachelor's Degree or Advanced Diploma) related qualification.
  • Relevant 3 years working experience in claims environment. 
 
Technical & Behavioral Competencies required
  • Computer Literacy.
  • Good Communication skills.
  • Effective negotiation skills.
  • Thorough knowledge of the claims operating system.
  • Advanced knowledge of Motor Vehicle Accident legislation.
  • Drafting and understanding undertaking procedures.
  • Knowledge of all legislation which pertains to the RAF procedures such RAF Act and all amendments, Contingency Fees Act, PAIA, Assessment of damages Act, PFMA.
  • Substantial medical knowledge of the human anatomy and the effects that injuries have on claimants.
  • Ability to meet and exceed monthly targets on a continuous basis as required by management.
  • Sound mathematical skills.
  • Knowledge of actuarial calculations and the ability to interpret and apply actuarial assumptions.
  • Personal mastery
  • Emotional wisdom
  • Ethics and governance
  • Customer orientation and customer focus
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Remuneration
A total cost to company of minimum remuneration package applicable to this position is R349 998.00  Per annum and will be negotiable commensurate with experience.
 
Closing date: 01 June 2021
 
APPLICATIONS CAN BE FORWARDED FOR ATTENTION OF THE RECRUITMENT OFFICER AT: ELNRecruitment.3@raf.co.za OR Hand deliver at 4th floor, Metropolitan building, c/o Caxton street and Drury Lane, East London.
 
INSTRUCTIONS TO PROSPECTIVE APPLICANTS
  1. Indicate the name and the reference number for the position you are applying for on the subject line
  2. Do not submit copies of qualifications and ID as these will be requested from shortlisted candidates on the interview date
  3. Submit a short CV with a maxim of 5 pages
  4. Please indicate your current salary and salary expectations if considered for the position.


The Road Accident Fund subscribes to the principles of employment equity and preference will be given to groups who are underrepresented in terms of our Employment Equity Plan
 
NB:
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 
  • NB: Preference will be given to people living with disabilities
 
It is the applicants' responsibility to have foreign qualifications evaluated by the South African Qualification Authority (SAQA) and to provide proof of such evaluation.