Large Loss and Complex Claims Specialist
2 days ago
Bedfordview, Gauteng, South Africa
CFS Recruitment
Full-time
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Minimum Requirements
- Matric.
- RE5 qualification.
- Degree in Law, Risk Management, Insurance, Commerce, or a related field.
- Class of Business certification (advantageous).
- FAIS Fit and Proper compliant.
- 510 years' experience in short-term insurance claims.
- Proven experience handling large losses and complex commercial claims.
- Experience managing claims valued at R1 million+.
- Strong technical exposure to:
- Commercial Property Claims
- Engineering Claims
- Liability Claims
- Business Interruption Claims
- Motor & Fleet Claims
- Experience drafting technical coverage opinions, claim determinations, and repudiation letters.
- Sound understanding of insurance law, policy interpretation, and claims governance
Key Responsibilities
- Manage large loss and complex claims from notification through to final settlement or closure.
- Assess policy coverage, exclusions, endorsements, warranties, conditions, and limits.
- Evaluate liability, indemnity, and quantum to determine appropriate claim outcomes.
- Review and validate repair quotations, replacement costs, business interruption calculations, and expert reports.
- Liaise with attorneys, loss adjusters, engineers, assessors, forensic investigators, brokers, and insured clients.
- Draft technical coverage opinions, repudiation letters, and settlement recommendations.
- Prepare business cases and ex gratia settlement motivations for senior management approval.
- Identify fraud indicators and escalate suspicious claims activity where necessary.
- Compile claims summaries, exposure analyses, and reserve recommendations.
- Provide technical guidance and support to internal stakeholders.
Competencies
- Advanced policy interpretation and coverage assessment skills.
- Strong analytical and investigative abilities.
- Excellent negotiation and conflict resolution skills.
- Strong decision-making and problem-solving capability.
- Exceptional stakeholder management skills.
- Ability to work independently and manage competing priorities.
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Large Loss and Complex Claims Specialist
1 day ago
Bedfordview, South Africa CFS Recruitment Full-time €35,000 ContractMinimum Requirements - Matric. - RE5 qualification. - Degree in Law, Risk Management, Insurance, Commerce, or a related field. - Class of Business certification (advantageous). - FAIS Fit and Proper compliant. - 510 years' experience in short-term insurance claims. - Proven experience handling large losses and complex commercial claims. - Experience...