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Senior Non-motor Claims Specialist
2 weeks ago
Matric Certificate and Regulatory Exams
Further Education and Training Certificate in Short-Term Insurance NQF 4, and / or a Higher Certificate in Short term Insurance - NQF 5
Class of Business certification (Personal Lines & Commercial Lines) Highly advantageous
Must be compliant with FAIS Fit and Proper requirements with track-record of working unsupervised.
Marine and Engineering knowledge Highly advantageous
Computer literate Microsoft Word, Excel, and Outlook
Experience in Commercial and Personal lines
At least 5-10 years relevant work experience in claims validations and settlement (both in Motor and Non-Motor claims, as well as in both Personal Lines and Commercial Lines classes of business)
Work experience within a licensed insurer, or Underwriting Manager
Sound technical knowledge and understanding of relevant short term insurance policy wording
Validation of claims in line with Company guidelines and Standard Operating Procedures
Management of Large loss and complex claims
Appointment of necessary providers
Authorizations / Settlement of claims
Rejection of claims
The main purpose of the Claims Specialists role is to validate and process short-term insurance claims following a fortuitous event. Working in close partnership with an allocated portfolio of brokers, the Binder and Outsource Claims Specialist will specifically make claims validation decisions on complex and high value Non-Motor Claims
The Claims specialist will also fulfill a coaching role, assisting and guiding binder and outsource brokers to make correct claims validation determinations on all claims that fall within their defined mandate
The Claims Specialist will oversee the training and oversight of the binder and outsource brokers
Processing payments within the turn-around time
Payment confirmations to Brokers and Suppliers
Relationship Management with allocated brokers, including training of brokers with binder and outsource agreements
Oversight and management of binder and outsource brokers
Complaints handling and resolution
Liaising with Service Providers
Liaising with brokers and clients
**Key clients**
Brokers, internal staff and managers, service providers & policy holders
