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Key Responsibilities:

Team Supervision and People management

• Take responsibility for all administrative functions in the Claims Handling Division through effective supervision of people
• Provide on-the-job training to claims handlers in order to comply and ensure uniform application of claims administration standards
• Train staff to comply with legal principles as well as company policies and procedures
• Co-ordinate follow-ups of all outstanding losses

Claims administration

• Compile a register to reflect all losses that need to be reported in accordance with the Public Finance Management Act
• Process and capture and confirm all new insurance
• Assist with renewal of insurance process (annually or as required)

Monitoring, Audit and validation

• Oversee insurance claims as submitted and received from claims handlers
• Audit claim files to ensure compliance to policy and procedures at all times
• Sign invoices/documentation in accordance with delegation of authority
• Ensure that insurable and uninsurable losses are processed according to company policies and procedures

Payments and Recons

• Implement and maintain systems of internal control that will ensure that end to end claims process and related transactions are performed efficiently and effectively
• Conduct weekly/monthly audits on correctness (policies and claim types) of claims captured within approved time frames, go-aheads given, open orders, outstanding payments of invoices/settlements
• Ensure that all claims are being settled within prescribed period
• Ensure all journals are captured on time and correctly and
• Perform high level oversight to assure correctness
• Ensure completeness of related reconciliations

Communication and reporting

• Maintain effective communication channels with internal and external clients to expedite claims
• Promote and facilitate a culture of quality output and efficiency within the claims administration environment

Professionalism

• Establish a professional work environment to enhance dealings with internal and external customers such as (e.g. insurance companies), service providers and members of the public.

Decision making

• Decision making to be done on all insurable incidents in accordance with the different insurance policies
• Makes recommendations to decision makers in accordance with the Financial Delegation of Authority
• Take decisions on problems presented by subordinates

Qualification:

• Minimum (NQF Level 4).
• A National Diploma (NQF Level 5 ) will be an advantage
• Any further qualification in or studying towards a financial or insurance related field will also be an advantage.
• Should be prepared to become a FAIS Key Individual and Representative and write the requisite exam

Experience:

• Minimum of 5 years’ experience within the risk management/insurance environment.
• 1 year experience in a supervisory/ team lead role
• Any insurance-related or customer service-related experience will be an added advantage.

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Key Responsibilities:

Strategic Planning:

• Develop a comprehensive Insurance (risk financing) strategy that is responsive and bespoke to organisational business risk exposures
• Identify market opportunities, consumer trends, and competitive threats to inform strategic decision-making within the insurance space.

Regulatory Key Individual:

• Key individual for insurance business – Effective and efficient management of the insurance licence for sustainable, profitable underwriting position for SAPO group for both 1st party and 3rd party products, and ensure operational compliance to FAIS Act.
• Through, Compliance and Regulatory, Interact with the FSCA and any other relevant statutory bodies on matters of Insurance compliance to ensure SAPO group adheres to identified standards and norms

Team Leadership:

• Lead and motivate multidisciplinary teams reporting to you, providing guidance, coaching, cross skilling and support to achieve performance targets and deliver exceptional results.
• Foster a collaborative and cross-functional work environment, encouraging teamwork and innovation to drive continuous improvement and excellence.
• Establish a quality culture for claims negotiating, settlement and approval
• Establish value added reporting structures to business units

Stakeholder Relationship Management:

• Establish a professional work environment to enhance dealings with internal and external customers such as legal professionals (e.g. insurance companies), service providers and members of the public.
• Maintain strong professional relationships with internal clients to understand their needs, address their concerns and act as a trusted insurance/risk advisor, ensuring effective communication, and conflict resolution to achieve mutually beneficial outcomes.
• Maintain strong professional relationships with strategic partners and stakeholders (Regulator and critical service providers)
• Drive optimum output through active performance management of critical service providers to ensure efficient service delivery.

Risk Financing Strategy Execution:

• Risk facilitation and process integration across the Group and– Initiate pro-active risk exposure identification processes at all levels within different Business Units and disciplines and formulate and advise on optimum risk finance response strategies where applicable.
• Formulate and table risk financing solutions and proposals to various business risk owners
• Risk control and risk awareness (Group level) – initiate cost effective programmes and reports to elevate awareness across the organisation and to various management levels
• Assess BU compliance against established insurance policy requirements, identify and communicate gaps and ensure resolution of identified issues in the form of adequate management actions
• Renewal of insurance process (annually or as required)
• Conduct benchmarks and gap analyses on established practices for continuous improvement
• Risk financing (Group level) – Exclusively for company assets, the most economical insurance placement for the Company; data collection; projecting scenarios, and shared with insurance providers to secure best premium
• Develop and execute Loss administration framework and legal recovery – through legal services
• Cell captive management (Group level) – Effective and efficient management of the insurance licence for sustainable, profitable underwriting position for SAPO group products, including assets
• Facilitate a process of embedding compliance to insurance principles within BUs through constant monitoring and provision of appropriate feedback, guidance and support

Performance Analysis and Reporting:

• Analyse integrated operational and financial data, KRI to constantly assess risk exposure against available cover for adequacy, and identify and advice on risk financing areas for optimisation and enhancement.
• Prepare regular reports, dashboards, and presentations for Executive management, providing insights, recommendations, and actionable strategies to drive continuous improvement and achieve business objectives.
• Issue monthly reports and recommendations to business units
• Ensure that all claims are being settled within prescribed period

Qualification:

• Postgraduate qualification (NQF Level 8) (Business/Finance/Risk Management or equivalent)

Experience:

• Minimum of 10 years multi-disciplinary experience across the organisation which must include core operations, financial management and risk management experience 
• At least 5 years in leadership or management role