Deputy Internal Arbitrator

The Office of the Internal Arbitrator receives and consider appeals or complaints from members or policyholders against final decisions made by PPS Insurance flowing from disputes between the parties. The office also responds to complaints received from the National Financial Ombud (NFO) that have not previously been seen by the office and attempts to resolve these directly with the complainant.

The office acts in an independent, impartial, and objective fashion and does not form part of any PPS operations. The Internal Arbitrator does not require any approval for his decisions and the Internal Arbitrator's decisions are binding on the Insurer.

The incumbent will, with the values of independence, integrity, and professionalism:

• Establish whether the internal remedies available to the complainant have been exhausted and if not, redirect the matter to PPS for finalisation.

• Resolve matters by way of mediation and if mediation is not appropriate, resolve the matter by determination.

Formal Qualifications:

• LLB Degree or equivalent qualification
• Matric

Experience :

• Atleast 5 years' experience as Legal Adviser in the long-term and/or short-term insurance industry or in dispute resolution.
• Knowledge of PPS products essential.

Key Responsibilities:

Case Management of Complaints

· Effectively manage complaint or appeal cases from initiation, through investigation to finalisation.

• Work across organisational boundaries in securing appropriate stakeholders support within agreed timelines.

• Identify the issues that form the subject of the complaint or appeal and the information required to resolve the identified issues.

• Apply extensive knowledge of PPS processes to determine if PPS has dealt with the complaint efficiently and effectively.

• Apply extensive knowledge of the PPS Provider Policy to cases to ensure that complaints are resolved in accordance with applicable contractual terms.

• Apply due weight to considerations of equity to ensure that complainants are dealt with fairly.

• Apply relevant legal principles to the facts.

• Submit determinations within a reasonable time and manage complainant expectations across the complaint journey.

• Draft quality determinations where:

o The main issues are comprehensively and clearly articulated.

o The writing style and language used is appropriate.

o The format and order of arguments is well organised.

• Identify systemic issues or themes emerging from complaints where appeals are found partially or wholly in favour of complainants or where compensation is awarded.

Office and People Support

· Attend weekly meetings with office staff to discuss cases and general issues of importance.

• Promote the sharing of ideas within the team to support consistency of approach.

• Develop the skills of employees by exposing them to cases, reviewing responses and providing technical guidance.

• Build and maintain team cohesion and effectiveness.

Record and submit key case indicators to the Internal Arbitrator Specialists to facilitate effective analysis of data and reporting on complaint categories and performance.

Relationship Building and Communication

· Collaborate effectively across business areas to achieve business objectives.

• Maintain effective relationships with staff of the NFO.

• Build and maintain relationships with PPS stakeholders across subsidiaries.

• Successfully leverage established relationships within PPS, systems, and process knowledge in order to initiate, conduct and finalise independent investigations.

Risk and compliance

· Remain updated and informed on related regulations and legislation (FAIS, POPIA, LTIA, STIA, PPR and TCF etc.)

• Manage complaints and appeals in line with applicable contractual terms and legal principles.

• Manage complaints and appeals in line with PPS internal policies and procedures.