Claims Examiner

Provide an efficient and professional Claims service to customers through prompt and fair settlement of Claims within mandate.
Contribute to business development and retention through positioning Claims and Claims service as an AIG product.
**PRINCIPLE DUTIES AND RESPONSIBILITIES**:
Claims Administration
Register the Claim according to procedure
Set appropriate reserves in line with policy
Determine if the loss is covered in terms of the policy
Assess the Claim based on accurate interpretation of policy wording in place: refer Claims outside Claims mandate
Appoint / recommend appointment of loss adjusters and/or relevant experts: provide appropriate settlement instructions
Follow Claims settlement process to ensure timely settlement of Claims and fees
Conduct timely, professional follow-up correspondence with Clients and Brokers, including Claims rejection
Provide reports to Claims Manager in line with Claims policies
Customer Service
Establish and maintain excellent levels of customer service, with particular attention to:
Responsiveness - speed of service delivery
Quality of service rendered
Adherence to internal and external SLA’s
Expense control
Manage all expenses within budget. Continuously work to reduce the expense ratio through constant attention to efficiencies and opportunities to maximize productivity through streamlining of processes
Audit and Compliance
Ensure adherence with and implementation of all claims compliance controls as may be specified from time to time by the Claims Manager.
**What we’re looking for**:
Qualification
Matric
Short Term Insurance qualification preferred
FAIS compliant
Experience
Minimum of 3 year’s experience as Claims Examiner, including experience in specific Line of Business, as appropriate.
**Core Competencies Requirements**:
Dealing with Ambiguity
Customer Focus
Negotiating
Drive for Results
Business Acumen
Problem Solving
Interpretation of legal agreements
Policies for Regulations
Portfolio Management
Reimagining insurance to make a bigger difference to the world
American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world’s most far-reaching property casualty networks. It is an exciting time to join us — across our operations, we are thinking in new and innovative ways to deliver ever-better solutions to our customers. At AIG, you can go further to support individuals, businesses, and communities, helping them to manage risk, respond to times of uncertainty and discover new potential. We invest in our largest asset, our people, through continuous learning and development, in a culture that celebrates everyone for who they are and what they want to become.
Welcome to a culture of belonging
We’re committed to creating a culture that truly respects and celebrates each other’s talents, backgrounds, cultures, opinions and goals. We foster a culture of inclusion and belonging through our flexible work arrangements, diversity and inclusion learning, cultural awareness activities and Employee Resource Groups (ERGs). With global chapters, ERGs are a cornerstone for our culture of inclusion. The diversity of our people is one of AIG’s greatest assets, and we are honored that our drive for positive change has been recognized by numerous recent awards and accreditations.
AIG provides equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories.
**Functional Area**:
CL - Claims
AIG South Africa