Manager: Complex Claims (JG7) at Santam Insurance

JOB DESCRIPTION

• The Complex Claims Manager is responsible for the handling, co-ordinating, managing, negotiating and settlement of large own damage personal, commercial and industrial lines short term insurance claims. 

The following accountabilities are applicable:

• Management of a claims’ portfolio, end-to-end. This includes but is not limited to:
• critical review of cover and endorsements / clauses specified in the policy 
• Appointment of appropriate resources
• Investigation of merits and the evaluation and interpretation of assessment / expert reports in line with the claims scenario
• Review and update estimates where necessary
• Manage client expectations
• Handle queries where necessary 
• Negotiation and Settlement with the client 
• Dealing with the rejections of claims
• Ensure finalisation of claims
• Communicate all adverse underwriting issues
• Liaison with internal stakeholders
• Managing of litigation / arbitration where rejections / settlement offers are in dispute
• Customer Relationship Management
• Serve as a Business Partner with all relevant Stakeholders
• Cost effective claims handling
• Claims Escalation
• Process Improvement
• Policy compliance 
• Legislative compliance 

QUALIFICATIONS AND EXPERIENCE

• Matric / Grade 12
• Completed Legal or Financial degree
• Relevant short-term insurance-related qualifications will be beneficial
• Minimum 3 to 5 years’ experience – own damage commercial and personal lines claims