Hanli Matthews, Insurance Claims and Customer Service Expert

About

Proactive, goal-driven, empathetic, and dedicated professional with experience and knowledge related to the insurance industry. Expertise in settlement negotiations, claims adjustments/settlements, information and data collection, research, investigations, and presentation skills. Adept at cultivating positive relationships and open lines of communication with clients, vendors, and colleagues.

Experience

PSG Insure, Gauteng, South Africa

May 2018 – Sep 2020

Gauteng Province, South Africa

Claims Team Leader, Personal & Commercial Insurance

Led daily operational activities and performance of the major incident claims team (12) closing a monthly portfolio of 2,500 – 3000 claims valued at ~$3.5M USD (major thefts, total losses (Auto, Property, and Business) and special covers (AGRI, CAT Storms, and Fire). Continually coached and mentored junior staff to multi-skilled senior consultants, developing into Team leaders. Delivered staff disciplinary action where needed and completed bi-annual staff performance reviews. • Reached a claims repudiation ratio of 30% due to non-compliance of cover or fraudulent claims. • Smoothly mitigated settlement disputes related to under-insurance and noncompliance with policy warranties. • Encouraged a culture of service excellence, production, cycle time and quality objectives through the recognition of top consultants in Quarterly Rewards for Best-In-Class incentives. • Cultivated an environment to improve the employee experience by identifying and addressing training needs and implementing continuous staff development. • Enhanced staff productivity levels through strategic remote team leadership during the COVID-19 pandemic. • Achieved a 99% claims handling accuracy level, cut claims costs, and increased productivity through adherence with SLA and prescribed Insurer rates, as well as daily report generation. • Lowered client loss rations by 10% by successfully mitigating settlement disputes and addressing/resolving challenging customer and Broker complaints while promoting brand loyalty and improving client retention. • Improved team efficiency and claims processing through the identification and matching of staff skills to requirements. • Increased team performance by 90% and eliminated unnecessary staff absenteeism by regular analysis of claims data and even distribution of workload. • Received numerous recognitions given by EXCO due to customer service excellence during my time worked at PSG Insure.

Brolink Insurance Administrators (PTY) Ltd.

Dec 2015 – Apr 2018

Gauteng Province, South Africa

Claims Supervisor, Commercial Claims Department, Independent Broker Division (Call Centre)

Oversaw and mentored a team of seven junior Commercial Claims Consultants to deliver enhanced product knowledge within claims mandate up to $10K USD. Generated and presented weekly reports to leadership related to outstanding claims estimates, staff workload, and daily monitoring of Insurer Claims Floats. Supported the creation of relevant Commercial Claims Procedure Manuals in alignment with relevant Insurer Binder Agreements and Mandates, Standard Operating Procedures, and signed Service Level Agreements. Effectively applied TPA, carrier, and client best practices when working with stakeholders within different industries (Transport, Construction, farm/ranching, industrial, meatpacking, recreation resorts, security firms, and staffing companies). • Decreased the re-open rate, the best result for average length of claims in two years. Successfully achieved a claims handling accuracy of 99% while auditing and approving claims within mandate of $10K USD to $50K USD. • Reached an average of 95%+ on Quarterly Review Audit Scores. • Reduced spending by overseeing the litigation of high exposure claims and delivering expert recommendations. • Achieved ongoing improvement of processes to achieve accurate benefits determinations ahead of due date by leading the complex analysis program for the Commercial Claims department.

Brolink Insurance Administrators PTY Ltd.

Jan 2005 – Nov 2014

Gauteng Province, South Africa

Senior Claims Examiner, Personal & Commercial Claims Department, Independent Broker Division (Call Centre)

Resolved and managed an average caseload of 200 open claims including complex and large loss catastrophe claims, with exposures ranging from $10K to $3M. Clarified coverage of losses and supported clients in locating alternative living arrangements with total Losses. Identified and investigated suspicious and fraudulent losses in collaboration with Insurance Assessors, Specialist Investigators, and local Police Stations. Conducted investigations and settling of complex large losses including claim files involved in litigation for the broker channels and direct platforms. • Delivered exceptional customer service to policyholders through the clear communication of important information, listening closely to and empathizing with all concerns, and resolving complaints for quick settlements. • Proactively oversaw all aspects of claim developments from investigation to recovery of subrogation payment of indemnity.

Education

INSETA (Insurance Sector Education and Training Authority South Africa)

Aug 2013 – Feb 2014

NQF Level 4 Technical diploma, Insurance

SA IFM (Insurance Financial Services Board South Africa)

Jun 2011 – Oct 2011

Regulatory Exam RE Level 5, Insurance Regulatory and Compliance Examinations

Brandwag Highschool, South Africa

Jan 1990 – Dec 1990

Highschool (GED), General

Hanli Matthews

Insurance Claims and Customer Service Expert

Skills

Languages