Personal Lines (Motor) Claims Manager Company NameNedbank at Nedbank

The Personal Lines Claims Manager will manage in-house claims and Third-Party Administrators with binder agreements authorised to process claims. Review any outsourced functions relating to motor claims including mandates. Collaborate on the Service Provider Panel and the Product development. Manage the reporting of average cost per claim targets, effective procurement utilisation and authorisation of claims.

Job Responsibilities

• Analyse profitability of multi-claimants or renewal of individual policies and recommend corrective actions to brokers or administration team.
• Discuss proposed amendments to pricing models and new covers with Actuarial team.
• Build and maintain effective relationships with key stakeholders.
• Ensure compliance with underwriting guidelines
• Quality monitoring and reporting on the selection of risks, classification and rating of risks.
• Compilation and review of all policy documentation and forms
• Guidance on retention and reinsurance
• Managing the motor claims team (inhouse or outsourced)
• Identifying trends and recommending improvements
• Ensure that procured service providers are utilised where applicable and cost, recoveries and salvage monitored, estimates and statuses are updated.  
• Ensuring that claim validations are being done in accordance with our mandate and the cover provided.
• Dealing with VIP clients & Brokers and ensure accurate and timeous response to brokers on queries
• Communicating changes to policies to U/W (Total loss).
• Risk Management / Reporting
• Authorising claims
• Adhering to binder claims mandates
• Claims account recons
• Reporting daily/weekly/monthly
• Process all claims over partial binder mandate. Evaluate and investigate all claims received in order to prevent possible leakage to the company in the settlement of claims. Management of outstanding claims on a monthly basis.
• Monitor claims SLA and ensure that transactions are processed within delegated authority limits and within set standards.
• Underwriters to be advised of claims revealing adverse risk features as soon as they are evident and reinstate policies where applicable. Detection and management of fraud, dishonesty, misrepresentation
• Roll out of the claim’s philosophy and framework within team and binder holders
• Managing rejections, ex-gratia claims and ensuring fairness and diplomatic communication
• Coordination of third-party recovery/liability claims
• Ad-hoc projects when required. Technical advice and other assistance over and above the normal claim’s duties.
• Customer service: Maintain a high level of service to customers (internal and external) according to the service standards as set by the company.
• Effective communication: Communicate effectively with external parties as well as claims team and other departments
• Take responsibility for your own career growth

Reporting:

Weekly

• Management reports
• Outstanding claims
• Urgent claims report – status update
• Risk reporting
• Rejected claims

Monthly

• Post loss/Multi claimant report – UW?
• Insurer reports
• KPI feedback

Quarterly

• Internal audit feedback
• Standard Operating Procedure review

Qualifications:

• Grade 12 (Matric Certificate) qualification
• Higher Certificate in Insurance or equivalent (highly advantageous)
• Regulatory Examinations (RE) qualification

Experience Level

• 5 - 7 years’ experience working in a personal lines claims department assessing risks
• Sound understanding of personal lines short-term insurance with at least 5 years’ claims experience including:  Claims procedures and knowledge; Underwriting procedures and Risk management; Reinsurance and treaties; Product and Financial knowledge
• Knowledge of Insurance Practices
• Sound understanding of the TCF principles
• 3 years management experience (non-negotiable)