Business Claims Advisor at MiWay Insurance Limited

Role Description

• The Business Insurance Claims Advisor is responsible for managing a portfolio of commercial motor and non-motor claims.
• This role requires the proactive and efficient processing of claims, ensuring fair and accurate assessments in line with policy wording.
• The ideal candidate will be a dedicated professional with strong technical claims knowledge, excellent communication skills, and a commitment to delivering exceptional service to brokers and policyholders within the short-term insurance sector

Minimum Requirements

Minimum Qualification Required

• Grade 12/Standard 10/NQF 4  
• A relevant tertiary qualification in insurance, business, or risk management is advantageous

Minimum Experience

• Minimum 3–5 years' experience in short-term insurance claims.
• In-depth experience managing both motor and non-motor commercial claims.
• Proven experience in business insurance or a corporate risk environment.

Deliverables:

• End-to-End Claims Management: Manage the full lifecycle of assigned commercial claims, including registration, assessment, negotiation, and settlement, ensuring adherence to service level agreements (SLAs).
• Policy Application & Assessment: Accurately interpret and apply policy terms and conditions to determine claim validity. Make sound decisions on liability and quantum to ensure fair outcomes for clients and the business.
• Client & Broker Communication: Serve as the primary point of contact for policyholders, brokers, and service providers. Provide regular, clear, and professional updates on claim status and manage expectations effectively.
• Risk Identification & Compliance: Adhere strictly to all regulatory requirements, internal protocols, and FAIS legislation. Identify and flag potential fraud, irregularities, or claims leakage for further investigation.
• Record Keeping & Administration: Maintain accurate and detailed records of all claim activities, decisions, and communications on the relevant systems to ensure a clear audit trail.

Competencies Required

• Claims Knowledge: Strong technical understanding of commercial insurance claims processes.
• Client Service: A proactive, solution-oriented approach to client and broker queries.
• Decision-Making: Sound judgement in claims evaluation, assessment, and settlement.
• Communication: Clear, confident, and professional communicator (both verbal and written).
• Organisation & Time Management: Excellent ability to manage a portfolio of claims and prioritize tasks effectively.
• Problem-Solving: Ability to analyze complex situations and resolve issues efficiently.
• Attention to Detail: Meticulous in reviewing documentation and maintaining accurate records.