Senior Claims Controller at Sasria

Qualifications:

• Relevant Diploma/ Higher Certificate in Insurance preferable
• Tertiary qualification preferable (NQF Level 6)

Experience:

• 4 – 6 years’ experience in a Claims handling position within short-term (non-life) Insurance Industry
• Motor Own Damage experience is an added advantage

Duties and Responsibilities

Claims Processes

• Deal with technically complex claims within their mandate.
• Verify and validate all documents under the policy cover and approve or reject claims within delegated authority.
• Exercise proper judgment and decision-making to analyse the claimed exposure, determine the proper course of action and appropriately finalise the claim.
• Escalate complex claims to Line Manager.
• Assist Junior Claims Controllers on technical claims.
• Ensure workflow is managed properly on CMS system.
• Daily (or as required by management) progress reporting.

Stakeholder Management (Agency/Broker & Service Provider Liaison)

• Engage with brokers and Agent companies promptly as required.
• Engage with Underwriting department on cover issues, inform them of gaps in cover and policy wording and provide them with any claims related data they may require. 
• Ensure identification of all claims where the appointment of legal representation or litigation is required or involved and advise the Line Manager, Claims Manager and relevant Executives. 
• Identify and discuss with Line manager appointment of service providers in line with DOA (Delegation of Authority).
• Engage any other department or stakeholder as required for the achievement of divisional goals.
• Manage service level agreements with suppliers and ensure deliverables are satisfactory.

Claims Operations

• Provide input into the improvement of claims processes and procedures in line with best practices. 
• Ensure compliance and risk management policies are adhered to in day-to-day claims activities.
• Assist line management in compiling claims performance statistics. 
• Provide input into potential improvement of policy wording and agent procedure manuals -based on gaps between Sasria and agent company.

Ad hoc Tasks

• Perform any reasonable tasks as and when required by the Line Manager.