Claims Manager: Inwards Reinsurance at Santam Insurance

The role

• Santam Re & International is seeking to hire a Claims Manager with the reinsurance inwards team. This is a permanent opportunity based in Tygervalley, Cape Town.

What will you do?

• As the reinsurance inwards claims manager, you will be responsible for the end-to-end process of claims received from cedents.  You will ensure that claims are handled efficiently, accurately and in compliance with company policies and regulatory requirements.
• This role requires strong analytical skills, managerial experience, attention to detail and the ability to build effective relationships with both internal and external stakeholders.

What will make you successful in this role?

Claims processing and oversight:

• Review, assess, and validate reinsurance claims for accuracy and completeness.
• Conduct thorough investigations into complex or disputed claims, collaborating with internal teams and external parties.
• Interpret and apply reinsurance treaty contract wordings to determine coverage and liability.
• Manage claims from notification to final settlement, ensuring accurate outstanding claims reserving and timely payments.
• Monitor large and complex claims, escalate issues and participate in settlement negotiations as needed.
• Analyse and communicate trends in relation to classes of business in operating territories. This includes claims trend analysis per cedent per underwriting year.
• Implement and improve efficiencies by employing various metrics and indicators (dashboards and other visualization tools, amongst others) to identify patterns in claims frequency, severity, types of loss and potential implications for the business.

Documentation and reporting:

• Maintain accurate and up-to-date claims records.
• Prepare regular and ad hoc reports on claims activity, trends and financial analysis.
• Analyse claims trends to identify emerging risks and areas for process improvement.

Claims framework and compliance:

• Draft and drive claims settlement philosophy, including mandates and thresholds for claims handling, in alignment with the Claims Committee guidelines.
• Ensure compliance with reinsurance contracts, internal policies, regulatory requirements and industry best practices.
• Drive Group claims policy implementation. Ensuring all claims handling procedures are aligned with internal standard operating procedures (SOPs).
• Maintain a sound system of internal controls supporting the accurate and complete processing of all claims transactions.
• Participate in internal and external audits related to reinsurance claims.

Stakeholder engagement and relationship management:

• Build and maintain strong relationships with cedents, brokers, internal and external stakeholders.
• Serve as the primary point of contact for claim-related matters, internally and externally.
• Represent the company in claims-related market meetings and industry forums.

Process improvement:

• Define, implement and drive claims strategy.
• Identify and implement opportunities for efficiency gains and operational improvements in claims handling.
• Regularly review and update SOPs to reflect process improvements and regulatory and policy changes.
• Automate processes within functional area to enhance operational efficiency.
• Build dashboards to support strategic decision making and the evaluation of outstanding claims reserve sufficiency per class of business, per territory, per underwriting year.

Leadership and team development:

• Lead, mentor and develop a team of claims professionals.
• Promote a culture of high performance, integrity and customer centricity.
• Support recruitment, training and performance management of claims staff.

Qualification and experience

• Ten or more years of experience in reinsurance claims management, with focus on inwards reinsurance.
• Five or more years of experience in managerial position or function.
• Strong analytical and problem-solving skills, with the ability to evaluate complex claims and make sound decisions.
• Proficiency in Microsoft Office suite and claims management software.

Skills

• In-depth knowledge of reinsurance structures, contract wordings and claims processes.
• Strong analytical skills.
• Problem solving skills.
• Conflict management.
• Systems thinking skills.
• Excellent written and verbal communication.
• Meticulous attention to detail and organisational skills.
• Human centred leadership and people management experience.
• Comfortable with claims management systems and data analytics tools.
• Professionalism and integrity in all interactions and decision-making processes.
• Values driven, discretion, and sound judgment.
• Ability to work independently and collaboratively in a fast-paced environment.
• Resilience and commitment to professional development and continuous improvement.