Group Claims Manager

2 weeks ago

Cape Town, Western Cape, South Africa O'Brien Recruitment Full time

Role Duties and Responsibilities:

  • Supporting regional claims leads with their daily supervisory duties to progress, investigate and settle all claims within the required SLAs.
  • Reviewing problematic claims (including bad risks) and providing recommendations to regional claims leads / agents based on claim evidence and relevant policy wording.
  • Proactively identifying fraudulent claims during reviews by scrutinising evidence and using claims agents' technical cycling experience and knowledge.
  • Analysing claim costs (presettlement), ensuring accurate capturing of final settlement figures on the financial summary and claims platform.
  • Work closely with the Head of Client Services to ensure that estimates reserved are correct and reviewed every month.
  • Handling of insurance complaints relating to customer service and claim outcomes.
  • Lead the underwriter claim referral process for all UK claims.
  • Lead the weekly/monthly claims forum meeting to address key issues and problematic claims
  • Active management of the reinsurance/recovery claims process to ensure that the Company recovers claims costs where appropriate.
  • Working with the claims leader to implement a store and salvage network to reduce claims costs through procurement agreements and salvage optimisation (UK).
  • Compiling weekly and monthly claims reports for the UK (including reviews on RAW partner reports).
  • Working with the Head of Client Services + QA team, to identify quality issues and implement a claims training program to develop the skills of the claims team.

Role Experience and Qualifications:

  • At least 7 years of insurance, claims and operations management experience
  • Relevant qualification (diploma/degree)
  • Must be able to operate in a deadlinedriven environment
  • Be able to manage the performance and efficiency of claims agents
  • Action and solutionsoriented approach to issues and improvement areas
  • Strong customer service focus.
  • Sound knowledge of claims administration procedures, insurance industry best practices, and claim metric reporting.
  • Use insurance knowledge to set a standard across all claims and processes

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