Claims Specialist: Liability at Santam Insurance

What will you do?

Claims Practice Management 

• Attend and manage all aspects related to a portfolio of specialist Liability claims such as claims registration, case management, drafting, diary, recoveries, and settlement negotiations.

• Draft settlement agreements and other legal documents within mandate as per the Claims Governance Folder.

• Strategically manage a portfolio of claims.

• Manage loss adjusters and attorneys appointment on matters and ensure compliance with agreed service level agreements.

• Monitor and manage legal spend of attorneys and loss adjusters.

• Manage system processing and compliance with systems by way of payments, updating signed off reserves, proper recordal of information etc.

• Attend to Operational duties as allocated 

• Actively manage and record claims above certain thresholds as per The Claims Governance Folder and report on matters to Claims Co and Executive where required.

• Comply with internal and external regulatory framework and internal and external processes and procedures in accordance with organisational standards.

• Draft processes and procedures that are compliant with relevant regulatory framework and applicable legislation. 

• Effectively liaise and interact with Underwriters. 

Analysis

• Consider, analyse and interpret insurance policy and the contractual impact thereof for the determination of coverage;

• Critically analyse the facts of the matter and their impact on the underlying policy.

• Draft opinions on the interpretation of coverage in relation to the facts and the applicable policy, present and motivate;

• Draft opinions on merits and quantum of matter with the relevant caselaw and legislation applicable;

• Apply critical thinking to ensure appropriate decisions on merits, quantum and policy response.

• Critically consider and evaluate information provided and identify information required.

• Conduct a strategic assessment of claims and make strategic decisions and recommendations on handling of claims.

• Develop and maintain an understanding of technical and legal aspects impacting on the policy’s operation. Make representations and recommendations on improved wording and trends identification to underwriters

Individual Claims Leadership

• Be involved in continuous training and development in respect of Case Law, Policy wording, etc. 

• Assist in identifying and developing SOP’s and processes to ensure claims department effectiveness.

• Take initiative in creating opportunities of interaction with Brokers and Insureds. 

Client Liaison (Internal and External)

• Liaise with clients to resolve queries to the satisfaction of the affected parties within the scope of authority and / or responsibility.

• Prepare for and attend meetings and consultation with brokers, insureds, legal representatives and loss adjusters.

What will make you successful in this role?

Generic

• Administrative Skills 

• Analysis and Judgement 

• Attention to Detail 

• Client Orientation 

• Communication Skills including negotiation 

• Follow Up 

• Initiative 

• Interpersonal Skills 

• Organisational Awareness 

• Planning and Organising 

• Teamwork 

• Computer Literacy 

Specific 

• Ability to strategise and drive a claim to finality 

Qualification and Experience

Experience 

• Previous non-motor liability claims handling experience 

Qualifications 

• Matric 

• Law Degree 

• Admitted attorney 

• FAIS compliance a preference 

Core Competencies

• Cultivates innovation - Contributing independently
• Customer focus - Contributing independently
• Drives results - Contributing independently
• Collaborates - Contributing independently
• Being resilient - Contributing independently

About The Company

Santam is the market leader in the general insurance industry in Southern Africa. We are a large, diversified, expanding and transforming company and whilst based in South Africa, we are rapidly moving into a number of emerging markets, both in Africa and Asia. 

Our success is rooted in our passion for our clients and everything we do is centered on our delivery of Insurance Good and Proper. We’re about people. People drive our business so it follows that we want to recruit the best people possible whether they work for us permanently or for a short time as temporary employees. 

At Santam we are committed to transformation and embracing diversity. This commitment is what drives us to achieve a diverse workplace with employment equity as a key goal to create an inclusive workforce, representative of the demographics of our society. In achieving our employment equity goals we give preference to applicants from the designated groups in alignment with the Divisions Employment Equity targets.