Head of Claims | Centurion at PSG Konsult Ltd

Closing date:    28-Oct-2026

Responsibilities:

• Maintain relevance of the STA Claims SOP by applying regular updates
• Ensure adherence to STA Claims SOP by Claims area (way of work, process adherence, JIRA usage, policy admin system usage)
• Ensure that the ratio of unanswered calls / total calls is less than 3%
• Claims complaints to be managed within budgeted ratio for financial year (e.g. 15 per 1000 claims)
• Oversight/management/handling of escalations from Advisers, clients and associated value chain parties
• Ensure SLA Adherence - Average 95% 
• Number of Reworks / Total number of claims - Not more than 3% - Team Average
• Ensure that QA function executes tasks as required and that results are leveraged to improve operational performance
• Ensure that Claims Manager/Team Leaders perform quality checks and drive improvement of employee quality/quality claims outcomes
• Manage Insurer and value chain partner relationships
• Ensure binder adherence
• Assist with Binder and other audits
• Develop and implement strategies that align with the company's broader goals and contribute to increased operational performance, profitability, and customer satisfaction
• Maintain and report on strategic, operational and tactical plans
• Oversight of complaints tickets logged, classification, management of execution, ticket governance reporting (Weekly), Group PMO pack reporting (weekly)

Key leadership requirements

• Develop and execute the claims strategy aligned to business and insurer objectives.
• Lead and motivate claims management teams to achieve operational and customer service targets.
• Drive a high-performance culture focused on service excellence and continuous improvement.
• Act as a member of the executive leadership team, contributing to broader business strategy.

Binder & Insurer Relationship Management

• Manage claims performance against binder agreements and service level agreements.
• Build and maintain strong relationships with insurer partners.
• Report on claims trends, loss ratios, leakage, customer outcomes, and operational performance.
• Ensure adherence to insurer mandates

Governance, Risk Management and Compliance 

• Ensure compliance with:
• FAIS
• PPR (Policyholder Protection Rules)
• POPIA
• Conduct Risk principles
• TCF (Treating Customers Fairly)
• Applicable insurer mandates and binder regulations
• Maintain strong claims controls and governance frameworks.
• Manage fraud detection, investigation, and prevention initiatives.
• Oversee audit findings and implement corrective actions. (This can be internal audit, risk audits or insurer binder audits)

Minimum requirements:

• Bachelor’s degree
• FAIS and RE compliant (RE1/RE5)
• KI experience and ability to be added as Key Individual of the business
• Proven experience in senior management role
• Proven track record of driving financial and operational performance within a division
• Experience in managing Claims environments
• Analytical capability and exposure to BI tools
• Experience in delivering automation and optimization initiatives
• Proven track record of interacting with Advisers/clients
• Excellent leadership skills
• Problem solving skills
• Deep understanding of South African insurance market, outsource/binder environment
• Policy administration system experience and a solid understanding of how insurance systems work
• Experience with workflow systems and experience within a Binder Holder or UMA will be beneficial

Competencies required:

• Calm under pressure
• Great communicator
• Structured/process driven
• Attention to detail
• Able to execute and follow instructions
• Eager to learn, improve and optimize
• Strategic & Decision-making mindset
• Customer-centric mindset
• High Integrity
• Accountability and ownership
• Resilient person
• Strong problem-solving ability