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Position Title: Complex Claims Controller

Job Summary Statement/Purpose:
The Complex Claims Controller will ensure effective processing of claims within the governed framework, to ensure compliance with the short-term insurance regulations as well as to assist the Claims Manager with the management of complex claims.

Current Status: Active

Contract Type: Fixed-Term Contract

Closing Date: September 22, 2021

Click here to apply

Qualifying Criteria

1. Claims processes
• Undertake claims processing by receiving registered claims that are within mandate, check & maintain correct reserves and keep a regular follow-up on outstanding documents
• Approve and settle claims within delegated authority after verification of all documents and validation thereof under the policy cover
• Assist in the extrapolation of monthly reports on claims

2. Agency/ broker Liaison
• Inform reinsurers, brokers, underwriting & legal departments and loss adjusters accurately and promptly of large losses
• Exercise proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim
• Ensure identification of all claims where appointment of surveyors, adjusters or legal representation or litigation is involved and advise the Claims Manager and relevant Executives
• Interpret related claims documentation and negotiate settlement and disposition of complex claims

3. Strategic assistance
• Provide input in the compilation of the departmental annual plan
• Provide input on the review of the claims processes
• Review and enhance the claims procedure manual for evaluation by the Claims Manager
• Continuously review departmental risks
• Establish gaps between industry developments and Sasria covers
• Compile Statistical Reports
• Manage service level agreements with suppliers and ensure deliverables are satisfactory

4. Perform ad hoc tasks
• Perform any reasonable tasks as and when required by the Line Manager

  • Degree / Diploma preferable
  • Higher Certificate in Insurance preferable
  • 7 – 10 years’ experience in a Claims position of short-term Insurance company
  • Sound knowledge of claims procedures
  • Understanding of claims analysis and settlement
  • Understanding relevant legislation
  • Understanding of Short Term, commercial and property insurance
  • Administration
  • Analytical thinking
  • Business writing
  • Claims management
  • Communication
  • Customer service
  • Interpersonal skills
  • Liability analysis
  • Analysing information
  • Managing information
  • Communicating clearly
  • Team working
  • Handling conflict
  • Customer centricity
  • Managing work
  • Driving results
  • A South African citizen of any gender, preference will be given to an EE candidate
  • The role will be in Illovo, Johannesburg