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ROAD ACCIDENT FUND (RAF) – SENIOR OFFICER: REPRESENTED CLAIMS
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 safe use of our roads
The Organisation requires the services of qualified individual for the following position will be based in Johannesburg Regional Office.
THIS IS AN INTERNAL AND EXTERNAL ADVERTISEMENT
SENIOR OFFICER: REPRESENTED CLAIMS T.A.S.K GRADE 12
SORC09042021JHB
LOCATION: Johannesburg
CLOSING DATE & TIME: 4/20/2021 11:55 PM
Purpose of the Job: is responsible to providing claims handling in complex matters and to supervise the team to ensure prompt and fair settlement of represented claims.
Key Performance Areas:
Supervise, Review and approve assessments on claims
- Review documentation or determine further documentation needed.
- Scrutinise claims documentation (e.g payslips, medico legal reports, hospital records etc.).
- Consider experts reports particularly actuarial calculations.
- Consider any prior payments/interim payments/WCC/ social grants.
- Knowledge of rules of collateral and accelerated benefits.
- Factor in contingencies n also consider merits allocated.
- Assess if appropriate offer is made
- Approval of offer and payments.
- Review and approve merits.
- Supervise assessors in respect of work to be done and work done.
Authorisation of the appointments of experts
- Approve the appointment of the relevant experts to qualify the benefits e.g. actuary, industrial psychologists.
- Review reports when approving quantum assessment.
- Authorise the appointment if the experts and give guidance on appointment of appropriate experts to claims handlers.
- Guidance regarding appointment of experts where required to calculate the value of benefits.
- Guidance on loos of support/ earnings calculations.
- Check details of income and fringe benefits in major sectors.
- Determine contingency deductions to be applied.
- Guidance on interpretation of the statutory Cap under the Amendment Act.
- Evaluate assessment and approve awards in terms of the RAF Act Study and interpretations of the contents of actuarial reports.
- Generating and comparing different calculation results by interpreting and utilizing the information in the reports.
- Consider and evaluate the appropriate application of contingencies and contextualize the actuarial reports.
- Generating and comparing different calculations results by interpreting and utilizing the information in the reports.
Evaluation of authorization of interim payments
- Consider any prior awards by WCC/EIL/SASSA.
- Confirm and approve the loss which should be paid as an interim payment.
- Approve payment if applicable.
- Evaluate requests or submission for interim payment on merits and authorize the same.
Provide technical support to the claims handlers/officers.
- To identify technical needs and training of subordinates.
- Keeping subordinates well informed of case law and recent developments.
- Providing legal/ medical advice, interpretation and application of law of claims facts.
- Assessment with interpretation of claim documentation and information.
- Assist with interpreting and evaluation of actuaries reports.
- Research and provision of case law in substantiation of various claims and legal issues.
- Interpretation of legal/ medical evidence, dispensing of recommendations and the provision of guidance.
Supervisory
- Attend to queries from both internal and external stakeholders.
- Maintain stakeholder relationships.
- Provide guidance in respect of files.
- Provide advice and guidance to claims sections in respect of duplicate or dummy files.
- Monitor and supervise compliance with RAF policies.
- Supervise referrals to resource and recoveries.
- Supervise termination of mandates.
- Ensure settlements are loaded onto offer control.
- Assessing the workflow of claims officers and assistants.
- Consult with and provide technical support to sub-ordinates.
- Directing tasks to sub-ordinates and establish work schedules and co-ordinate activities of the section.
- Report on planned activities of the section.
- Approve offers in accordance with mandate.
- Maintain discipline and implement disciplinary sanctions where necessary.
- Authorisation and appointment of experts.
Effective and efficient human resources management
- Ensure proper planning and allocation of consistent workload within the section.
- Monitor performance of employees.
- Identify and ensure sufficient training and development of trainees.
- Facilitate regular team's meetings.
- Ensure that good employee relations are maintained.
- Provide ongoing support and coaching for employees.
- Ensure that all employees have entered signed performance contract agreement.
- Conduct employee review assessments
Report on the performance of the sections
- Keep record of statistics and supervise sections performance.
- Administer performance analysis of the section.
- Compile and maintain statistics on section activities for reporting.
- Keep daily stats of activities on work allocated and work to be done.
- Submit daily and monthly progress reports to the manager.
- Ensure effective and efficient recording of daily activities to the section.
- Compile monthly progress reports.
- Reporting on a daily on the daily finalization for the team.
- Reporting weekly with regards to the team case flow relating to trial and pre-trials.
Quantification and authorization of claims and claims settlement offers in accordance with mandate
- Drafting, inspection and approval of executive/ claims summaries for claims settlements in excess of officers' mandate.
- Submission of executive/claims summaries for settlement in excess of R900 000.
- Examination and approval of claims settlement offers and tenders between R150 000 to R350 000.
- Facilitate communication with all level of stakeholders.
- Ensuring compliance with the RAF values.
- Manage panel attorneys with reference to the SLA.
- Engage and negotiate with plaintiff's attorneys.
- Dispensing assistance to direct claimants and members of the public.
- Ensuring that the litigation process as a whole is properly instructed to act or settle a claim.
- Ensuring that the litigation process as a whole is properly observed and issues related thereto are attended to and managed by the team.
- Administration of trial matters and trial dates by virtue of a calendar/diary.
- Authorisation of the appointment of experts.
- Liaising with, discussing legal/claims issues and directing instructions to panel attorney and advocates via mail., telephone or email.
- Conveying instructions to defend, settle or tender to panel attorneys and advocates vial mail, telephone or email.
- Quasi decision making function- pertains to litigated matters where the senior exercises a quasi-decision making function which will result in settlement of the matters, without running the full litigation process and thereby reduce costs.
- Research, analyse and evaluate new service delivery methods, procedures and techniques.
- Ensure the application of rules and procedures to ensure high level of activity.
- Ensure the daily targets are accomplished.
- Ensure that work related problems are resolved expediently.
- Ensure execution of targets in accordance with the DOA.
- Ensure consistent application of policies and procedures within the section.
- Ensure that the usage and allocation of resources within the sections is in line with the PFMA.
- Employ project management principles to implement regular ad hoc projects, to ensure the team's compliance to the project parameters and timely achievement of targets and objectives.
- Introduce measures to monitor progress, keep statistics and report.
Qualifications and Experience:
· NQF 7 (Bachelor's Degree or Advanced Diploma) related qualification to discipline.
- Relevant 4 years' experience in the claims environment of which 1 year must have been on a supervisory level.
Technical and behavioural competencies required:
- Organisational resilience
- Team resilience
- Personal mastery
- Judgment and decision making
- Emotional wisdom
- Ethics and governance
- Customer orientation and customer focus
- Ability to assess and calculate quantum
- Knowledge of updates on earnings table, pension fund and impact on loss of support.
- Knowledge of rules and collateral and accelerated benefits.
- Formulation and submission of statistical reports.
- Thorough knowledge of the claims operating system.
- Knowledge of rules of collateral and accelerated benefits
- Knowledge of the RAF Act, Amendment Act, Third party Law, Law o persons, Law of Delict, Children's Act, Appointment damages Act, Assessment of Damages Act, Compensation for Occupational Diseases Act, PFMA, High Court Act, Magistrate Court Act, High Magistrate Court rules,
Remuneration:
Total cost to company of the minimum remuneration package applicable to this position is R502 953.00 per annum and will be negotiable commensurate with experience.
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"
Closing date: 20 April 2021
Applications can be forwarded for attention of the recruitment officer at Johannesburg; e-mail address is Jhbrecruitment3@raf.co.za or Hand delivered at 8-10 Junction Avenue, Block A, Parktown, Johannesburg.
INSTRUCTIONS TO PROSPECTIVE APPLICANTS
- Indicate the name and the reference number for the position you are applying for on the subject line
- Do not submit copies of qualifications and ID as these will be requested from shortlisted candidates on the interview date
- Submit a short CV with a maxim of 5 pages
- Please indicate your current salary and salary expectations if considered for the position.
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
- It is the applicants' responsibility to have foreign qualifications evaluated by the South African Qualification Authority (SAQA) and to provide proof of such evaluation.