Main Job Function
The main purpose of the Claims Specialist’s role is to validate and process short-term insurance liability claims. The Claims Specialist will provide guidance and legal advice on the interpretation of policy wordings, coverage under the respective policies, undertake merit/liability assessments as well as quantification in respect of large and/or complex claims, deal with litigation, and assist with all complaints made to insurance regulatory bodies.
Qualifications
- Regulatory exam
- Formal degree in risk management or short-term insurance
- Formal law degree preferred
Criteria
- ✓ At least 5-10 years’ relevant work experience in claims validations and settlement (both in Motor and Non-Motor claims, as well as in both Personal Lines and Commercial Lines classes of business) or work experience in a law firm specializing in dispute resolution, litigation, and insurance.
- ✓ At least 5 years’ experience in dealing with all aspects of Liability claims
- ✓ Experience in dealing with litigious matters
- ✓ Must be experienced and mandated to make claims settlement determinations for large losses and/or complex commercial claims (R 2 million or higher)
- ✓ Work experience within a licensed short-term insurer, or Underwriting Manager
- ✓ Sound technical knowledge, understanding, and practical application of relevant short-term insurance product wording, including niche products such as Marine and Engineering.
- ✓ Experience in complaints resolution (Regulatory and OSTI related)
- ✓ Review and approval of rejections
- ✓ Participation in operational claims management meetings with managers, brokers, and portfolio managers.
- ✓ Provide key guidance, advice, and recommendations for improvement in policy wordings
- ✓ Provide governance advice in terms of the relevant legislative and regulatory regime
- ✓ Ability to plan and prioritize own time and work commitments to deliver timeous claims service within agreed turn-around times
- ✓ Ability to think independently and to work without supervision.
- ✓ Ability to take initiative and respond pro-actively and independently to situations to secure positive results
- ✓ Accepts ownership and accountability for one’s own actions and decisions
- ✓ Is open to learning opportunities and is committed to continuous self-development
- ✓ Ability to communicate openly, and with impact
- ✓ Ability to adapt one’s communication style and content to the audience and context.
- ✓ Ability to easily connect with others and develop professional relationships and partnerships with others
- ✓ Strong listening skills
- ✓ Demonstrate high levels of customer centricity and empathy
- ✓ Effective numerical skills and ability to think analytically with good attention to detail
- ✓ Ability to identify risks and trends in relation to liability claims.
- ✓ Solution-based thinking
- ✓ High levels of self-perception (confidence, self-empowerment, optimism, self-respect)
- ✓ Ability to function independently, demonstrating good control.
Salary
R40k – R50k per month
A Consultant will be in touch if you are shortlisted for the position. Please consider your application unsuccessful should you not have been contacted within 2 weeks. We will keep your CV on our database and contact you should you match the criteria of any other vacancies.
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