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Non Motor Field Claims Examiner

1 week ago

Newcastle, KwaZulu-Natal, South Africa Santam Insurance Full time
Job Summary
Santam Insurance is seeking a highly skilled Field Non-Motor Claims Adjuster to join our team in Newcastle. As a key member of our claims department, you will be responsible for determining the quantum and merit of segmented non-motor claims by performing investigations, verifying the description of the event with the loss, negotiating with clients, intermediaries, and service providers, and settling claims within a delegated threshold and according to contract conditions.

About the Role
This is an exciting opportunity to work with a leading insurance company in Southern Africa. As a Field Non-Motor Claims Adjuster, you will be working closely with clients, brokers, and internal stakeholders to resolve claims in a fair and efficient manner. You will be responsible for conducting investigations, gathering evidence, and making recommendations to settle claims.

Key Responsibilities
* Receive instruction from scheduler on appraisal notes and documents. Review and confirm completion and accuracy of documents, policy, and conditions that pertain to the claim.* Plan routes for claims, make arrangements, and contact clients.* Identify what is required and outstanding from the client.* Review merit and plans for what needs to be investigated and whether specialist expertise is required (e.g., a builder or engineer).* Visit the client and validate the loss.* Interact with the client and perform a physical inspection of inventories. Complete Value at Risk and Inventory with the Client.* Appoint specialist resources if required.* Assess risk to provide recommendations to underwriting.* Interact with the SAPS, weather bureau, etc., to assess merit.* Compare info collected to the policy requirements and claim details presented.* Item identification (value and proof of ownership).* Determine equivalent replacement value by contacting suppliers and getting input from experts/moderators.* Decide and negotiate on replacement, cash, or claims card.* Authorize repairs or cash settlement.* Write claims report; authorize settlement, details of claim, findings, circumstances, merit, quantum, or risk recommendations.* Update the Claim File and associated documents to the Central Filing System with Santam (DPC).* Handle complaints, queries, and interactions with clients, intermediaries, service providers, internal stakeholders, relationship managers, claims committee, and options from underwriters.* Responsible for all policy sections, including damage to buildings (e.g., ceiling and carpets), pertaining to personal lines.* Responsible for all policy sections of an agricultural nature (excluding motor, BI, internal and external risk, and liability).* Authority to appoint field experts (e.g., builder or electronics specialist).* Required to moderate claims (i.e., building, electronic items, and jewelry) between the value of R35,000 and R150,000 for current segmentation rules.

Requirements
* Matric* Completed short-term insurance qualification (NQF4)* 3 to 5 years of Non-Motor field experience.* All relevant product training completed.* Familiar with IM external systems.* Must have experience in adjusting process, assessor reporting tools, building terminology, repair estimation on building damage, indemnity issues, non-standard roofing (e.g., thatching), floor coverings, gyproc, building repair calculator, and advanced electronic equipment.* Ability to conduct investigations on buildings, contents, and agriculture.* Ability to effectively communicate and build good rapport.

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