Claims Specialist

CAREER OPPORTUNITY

Santam Marine has a career opportunity for a Claims Specialist in the Claims department which will be based in Gauteng.

The successful candidate will manage a complex portfolio of claims from notification to closure, investing the necessary level of involvement required for each claim depending on, inter alia, the nature, category, maturity, type and quantum of the claim. This includes but are not limited to:

KEY RESPONSIBILITIES

Individual Claims Leadership

• Ensure correct segmentation of claims to claim handlers based on their mandates and their technical skill set
• Assist with continuous training of Team Members in accordance with Legal Developments and new products being offered
• Always follow Santam Marine Claims Reserving Philosophy and Claims Standards.
• Develop, iterate, document and execute claims strategies considering uncertainties, key decisions, potential outcomes and estimated associated costs.
• Understand and implement Santam Marine's "Treating Customers Fairly" policy.
• Understand and execute the requirements set out by the Internal Osti and Client Liaison division for complaints within the ethos of Santam Groups Claims Framework.

Claims Portfolio Management

• Manage claims portfolio(s) to optimise performance including:
• Regularly review individual claims within the portfolio and keep reserves and records up to date as required by Santam Marine claims controls and standards.
• Identify issues and trends in the portfolio and take appropriate and/or corrective action.
• Ensure that all claims rejections are referred to Management for discussion before submission to Client.
• Demonstrating thorough and sound application of policy knowledge to claims.
• Display fair legal understanding in dealing with technical complex claims.
• Deal with complaints internal and external (OSTI) complaint, and escalate accordingly
• Escalate problem claims to team leader, senior claims specialist and management (summons/brand and or reputational damage/complaints and near miss losses)

Working with Underwriters

• Develop an understanding of marketing and underwriting strategies for your business area and contribute to business development and renewal opportunities by attending client meetings to explain the Santam Marine claims philosophy and approach to claims handling and discussing any claims issues.
• Provide input to underwriters on review of potential or existing insured's claims experience.
• Provide feedback on claims trends and developments and their potential impact on the book. Collaborate with the marketing and underwriting regarding grey areas on policy wordings.
• Collaborate with the marketing and underwriting regarding grey areas on policy wordings.
• Authority and Minimum Standards Observance
• Operate within your approved claims authority at all times.
• Implement minimum operating and claim standards.
• Have thorough knowledge of industry regulations and minimum standards to ensure compliance with the regulations and Santam Marine claims and underwriting control standards and protocols.

KEY RESPONSIBILITIES

Third party Management

• Follow Santam Marine claims procedures for the selection and retention of third-party professionals and manage these relationships to the benefit of Santam Marine claims.
• Where required conduct claim file reviews or audits and resolve any issues identified.

Broker and Insured Relations

• Work proactively to develop and manage strong relations with key brokers and insureds.
• Promote the Santam Marine brand of excellence and professionalism in client service.
• Updates and follow-ups with Brokers and Surveyors.
• When required, provide Broker with Loss Ratio Reports.
• Where required attend meetings with Relationship Managers, ensure that the Claims Manager is included.
• Claim Specialist and Claim Handler's should not attend to meetings without a team leader and/or management.

Conflict of Interest

• Adhere to Santam Marine Conflicts of Interest policy, alert the appropriate person to any potential conflicts of interest and take steps to resolve them promptly.
• Immediately advise Head of Department if any Santam Marine Claims employee seeks to exert undue influence on you or any other team member to act improperly in the management, reserving or settlement of any claim.

People Management

• Day-to-day assistance and collaboration with the Claim Handlers in respect of review (JHB/Coastal) mentoring and on the job training.
• Contribute to, encourage and ensure teamwork to promote a healthy and engaged workforce.
• Review adjustments of Claim Handler/s.

Client Liaison (Internal and External)

• Respond to queries and resolve to the satisfaction of the affected parties within the scope of authority and / or responsibility.
  
  Prepare for and attend meetings.
• Report to Team Leader and Management complex claims and issues relating to the complex/large losses.

QUALIFICATION and EXPERIENCE

• Matric
• Fais
• Post Graduate (optional)
• Minimum 3-5 years actual marine specialist liability claims experience including an understanding of reinsurance facultative inwards and outwards and complex matters

COMPETENCIES

• 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

ABOUT SANTAM

Santam is the market leader in the general insurance industry in Southern Africa. As a large, diversified, and expanding company, we are committed to transformation and growth. While our headquarters are in South Africa, we are rapidly extending our presence into emerging markets across Africa and Asia.

With a client base of over 1 million policyholders, Santam serves individuals, commercial enterprises, specialist business owners, and institutions—including 80 of the Top 100 companies listed on the JSE. Our commitment to Insurance, Good and Proper goes beyond just providing cover—we offer peace of mind, ensuring our clients can focus on living in the moment, not worrying about the unexpected. Because at Santam, we believe the freedom to seize every day is worth protecting.

People drive our business, and we are committed to attracting the best talent, whether for permanent roles or short-term opportunities.

Santam is committed to diversity, inclusion, and belonging. As an equal opportunity employer, we encourage applications from candidates of all backgrounds, including persons with disabilities. We are dedicated to neuro-inclusivity and fostering a workplace where everyone can thrive.

Take the next step in your career—apply now and be part of a company that's shaping the future of insurance. This is Freedom