Group Claims Manager

4 weeks ago

Stellenbosch, South Africa Exceed Hr Full time

**Reference: NB 7605**

**Consultant: Nine Broodryk**

Location: Can be based in Stellenbosch or Woodstock

**Descriptions**:

- 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 (pre-settlement), 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.

**Qualifications**:

- At least five years of insurance, claims and operations management experience
- Insurance qualification (diploma/degree)
- Must be able to operate in a deadline-driven environment
- Be able to manage the performance and efficiency of claims agents
- Action and solutions-oriented 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

**Job Types**: Full-time, Permanent

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