Senior Claims Specialist

CAREER OPPORTUNITY
Santam SHA
has a career opportunity for a
Senior Claims Specialist
in the Claims department which will be based in Gauteng.

*KEY RESPONSIBILITIES*
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:

Claims Portfolio Management

• 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.
• Provide feedback to leadership for all internal and external (OSTI) complaints withing the agreed service level agreement.
• Escalate problem claims to management (summons/brand and or reputational damage/complaints and near miss losses)
• Follow at all times Santam Marine Claims Reserving Philosophy and Claims Standards.
• Provide input to develop and execute claims strategies considering uncertainties, key decisions, risk management, 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.

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, underwriting and leadership 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.

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.

*KEY RESPONSIBILITIES
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 remainder of team in respect of review, sign off, mentoring and on the job training as and when required.
• Contribute to, encourage and ensure teamwork in order 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.

General Administration

• Produce reports when required (Claims Summary).
• Attend to the typing of general correspondence when necessary.
• Attend to daily administrative routine tasks in accordance with organisational standards, processes and procedures. Appointment of recovery agents for third party recoveries.
• Reviewing/Assessment of survey reports
• Claim Adjustments
• Appointment of Attorneys
• Kit estimate, note updates and Kit diary follow-up's
• Review and check adjustment
• Check and sign-off claim payment
• Check and sign-off FX payments
• Verify Bridger checks
• Maintain a filing system - All documents must be uploaded onto MFiles

*QUALIFICATIONS AND EXPERIENCE*

• Matric
• Fais Compliance a preference
• Relevant Legal or Commercial degree a preference
• Minimum 7 years actual marine specialist liability claims experience including an understanding of reinsurance facultative inwards and outwards and complex matters

COMPETENCIES

• Good written and verbal communication skills.
• Computer literate
• Written and Verbal communication skills (English)
• Excellent negotiation skills
• Development of critical skills and capabilities
• Excellent accounting and reconciliation skills for claim adjustments

Additional Competencies And Skills

• Strong Attention to Detail
• Demonstrates Initiative
• Strategic thinking and planning that challenges assumptions
• A conceptual, lateral and analytical thinking balance
• Excellent communication skills and ability to lead meetings
• Strong relationship and general management skills
• Financial skills (budget management)
• Delivery/ results orientation
• Process management and improvement
• Conflict resolution
• Strong negotiation and influencing skills
• Strong Team focussed approach
• Strong Focus on Risk and TCF

About Samtam
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