Claims Specialist

**Claims Specialist**

An insurance company has a new position available for a Claims Specialist: Liability who will be based in Johannesburg - Illovo.

**Minimum Requirements**
- Experience 2 years in Liability / PI claims (handling at an insurer or litigation at an attorney firm)
- Matric
- Legal qualification required

**Duties**

Claims Practice Management
- Attend and manage all aspects related to a portfolio of high quantum specialist Liability claims such as claims registration, case management, drafting, diary, recoveries, and settlement negotiations.
- Draft settlement agreements and other legal documents within the mandate.
- Strategically manage a portfolio of claims.
- Manage loss adjusters and attorneys' appointments on matters and ensure compliance with agreed service level agreements.
- Monitor and manage legal spending of attorneys and loss adjusters.
- Manage system processing and compliance with systems by way of payments, updating signed-off reserves, proper recordal of information, etc.
- Attend to Operational duties as allocated
- Compile and manage risk reports when required
- Actively manage and record claims above certain thresholds on Risk Module and report on matters to Claims Co and Executive where required.
- Comply with the internal and external regulatory framework and internal and external processes and procedures in accordance with organizational standards.
- Draft processes and procedures that are compliant with the relevant regulatory frameworks and applicable legislation.
- Effectively liaise and interact with Underwriters.

Analysis
- Consider, analyze and interpret insurance policy and the contractual impact thereof for the determination of coverage;
- Critically analyze the facts of the matter and their impact on the underlying policy.
- Draft opinions on the interpretation of coverage in relation to the facts and the applicable policy, present and motivate;
- Draft opinions on merits and quantum of matter with the relevant case law and legislation applicable;
- Critically consider and evaluate the information provided and identify the information required.
- Conduct a strategic assessment of claims and make strategic decisions and recommendations on the handling of claims.
- Develop and maintain an understanding of technical and legal aspects impacting the policy’s operation.
- Make representations and recommendations on improved wording and trends identification to underwriters

Individual Claims Leadership
- Provide appropriate and required level of involvement, assistance, and/or guidance to junior Claims Staff;
- Assist the Management team in providing continuous training and development to the claims department
- Assist in identifying and developing SOPs and processes to ensure claims department effectiveness.
- Take initiative in creating opportunities for interaction with Brokers and Insureds.

Client Liaison (Internal and External)
- Liaise with clients to resolve queries to the satisfaction of the affected parties within the scope of authority and/or responsibility.
- Prepare for and attend meetings and consultations with brokers, insureds, legal representatives, and loss adjusters

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

**Salary**: Up to R450,000.00 per year

Application Question(s):

- Do you have a legal qualification?

**Education**:

- High School (matric) (preferred)

**Experience**:

- Liability / PI claims: 2 years (preferred)