Long-term Complaints Handling & Claims Resolution Agent

Long-term Complaints Handling & Claims Resolution Agent (x2)

Role Description

Complaints handling and claims resolution, including support of the Customer Service mailbox.

A Long-Term Complaints & Claims Resolution Agent manages and resolves complex, escalated, and aged customer complaints and claims, ensuring fair and timely outcomes.

Key Responsibilities

The role involves detailed investigation, root cause analysis, and collaboration with internal stakeholders, while maintaining compliance with regulatory standards and delivering a positive customer experience.

The Long-Term Complaints & Claims Resolution Agent is responsible for managing and resolving complex, escalated, and aged customer complaints and claims from start to finish.

This role requires conducting detailed investigations, identifying root causes, and working closely with internal departments to ensure fair, accurate, and timely resolutions.

The agent serves as a key point of contact for customers throughout the resolution process, providing regular updates, managing expectations, and handling sensitive situations with professionalism.

The role also ensures compliance with company policies and regulatory requirements while identifying trends and opportunities to improve complaint-handling processes.

Minimum Requirements, Experience & Qualifications

Matric (Grade 12)

2–3 years’ experience in long-term insurance (life, funeral, disability, or investment products).

Prior complaints handling or claims resolution experience.

Familiarity with ombudsman processes and escalation procedures.

Relevant insurance qualifications (e.g., NQF Level 4 or higher in insurance or financial services)

Compliance with Fit and Proper requirements under the Financial Advisory and Intermediary Services Act (FAIS).

Regulatory frameworks: FAIS, TCF (Treating Customers Fairly), POPIA (Protection of Personal Information Act).

FAIS and RE Qualification

FAIS compliant

RE5 certification

Financial Industry Qualifications or Compliance

Understanding of TCF principles

POPIA/data privacy awareness

Knowledge of Ombud processes (e.g., OSTI, FAIS)

Competencies

Analytical & problem-solving skills

Strong communication (verbal & written) to manage sensitive client complaints

Conflict resolution & de-escalation

Attention to detail & accuracy

Stakeholder collaboration

Time management & organization

Customer-focused approach

Regulatory awareness

Ability to work under pressure and manage high call volumes or case loads

"What's in it for you"

Opportunity to handle complex, high-impact cases

Exposure to regulatory and compliance frameworks

Skill development in investigation and problem-solving

Career growth within complaints, risk, or compliance roles

Ability to make a meaningful impact on customer outcomes

Experience working with cross-functional teams