Claims Specialist: Casualty Claims

8 months ago

Johannesburg, South Africa Santam Full time

What will you do?

This career opportunity is available at SHA Risk Specialists a division of Santam for a Claims Specialist: Casualty Claims, who will be based in Johannesburg: Illovo. What will make you successful in this role?

Claims Practice Management
Attend and manage all aspects related to a portfolio of specialist claims such as claims registration, case management, drafting, diary, recoveries, and settlement negotiations.
Draft settlement agreements and other legal documents within mandate as per the Claims Governance Folder.
Strategically manage a portfolio of claims.
Manage loss adjusters and attorneys appointment on matters and ensure compliance with agreed service level agreements.
Monitor and manage legal spend 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 as per The Claims Governance Folder and report on matters to Claims Co and Executive where required.
Comply with internal and external regulatory framework and internal and external processes and procedures in accordance with organisational standards.
Draft processes and procedures that are compliant with relevant regulatory framework and applicable legislation.
Effectively liaise and interact with Underwriters.

Analysis
Consider, analyse and interpret insurance policy and the contractual impact thereof for the determination of coverage;
Critically analyse 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 caselaw and legislation applicable;
Critically consider and evaluate information provided and identify information required.
Conduct a strategic assessment of claims and make strategic decisions and recommendations on handling of claims.
Develop and maintain an understanding of technical and legal aspects impacting on the policy’s operation.
Make representations and recommendations on improved wording and trends identification to underwriters

Individual Claims Leadership
Be involved in continuous training and development in respect of Case Law, Policy wording, etc.
Assist in identifying and developing SOP’s and processes to ensure claims department effectiveness.
Take initiative in creating opportunities of 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 consultation with brokers, insureds, legal representatives and loss adjusters. Qualification and Experience

Matric
Law Degree
Admitted attorney
FAIS compliance a preference
Previous non-motor liability claims handling experience Skills

Ability to strategise and drive a claim to finality
Administrative Skills
Analysis and Judgement
Attention to Detail
Client Orientation
Communication Skills including negotiation
Follow Up
Initiative
Interpersonal Skills
Organisational Awareness
Planning and Organising
Teamwork
Computer Literacy Core Competencies Being resilient - Contributing dependently Customer focus - Contributing dependently Collaborates - Contributing dependently Cultivates innovation - Contributing dependently Drives results - Contributing dependently About The Company

Santam is the market leader in the general insurance industry in Southern Africa. We are a large, diversified, expanding and transforming company and whilst based in South Africa, we are rapidly moving into a number of emerging markets, both in Africa and Asia.

Our success is rooted in our passion for our clients and everything we do is centered on our delivery of Insurance Good and Proper. We’re about people. People drive our business so it follows that we want to recruit the best people possible whether they work for us permanently or for a short time as temporary employees.

At Santam we are committed to transformation and embracing diversity. This commitment is what drives us to achieve a diverse workplace with employment equity as a key goal to create an inclusive workforce, representative of the demographics of our society. In achieving our employment equity goals, we give preference to applicants from the designated groups in alignment with the Divisions Employment Equity targets.

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