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 furthermore provide guidance and advice (legal) 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 recommendation for improvement in policy wordings
✓ Provide governance advice in terms of the relevant legislative and regulatory regime
✓ Ability to plan and prioritise 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 and
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.
To apply for this job email your details to robynk@armstrongappointments.com