Claims Specialist (Marine)

Sanlam Limited; Gauteng; On-site; ZAR 500 000 - 750 000; Full time

Job summary

A leading insurance provider has a career opportunity for a Claims Specialist in Gauteng. The successful candidate will manage a complex portfolio of marine claims, ensuring compliance with company standards and client satisfaction. They will need a minimum of 3–5 years of marine specialist claims experience and strong administrative skills. Applications are encouraged from diverse backgrounds.

Qualifications

• Minimum 3–5 years of actual marine specialist liability claims experience.
• Understanding of facultative reinsurance inwards and outwards and complex matters.

Responsibilities

• Manage a complex portfolio of claims from notification to closure.
• Ensure correct segmentation of claims to claim handlers.
• Assist with continuous training of team members.
• Develop and execute claims strategies.
• Understand and implement Santam Marine’s treatment policies.

Skills

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

Education

Matric

Post Graduate (optional)

Job description

Overview

Santam Marine has a career opportunity for a Claims Specialist in the Claims department 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 factors such as the nature, category, maturity, type, and quantum of the claim. This includes but is not limited to:

KEY RESPONSIBILITIES

• Ensure correct segmentation of claims to claim handlers based on their mandates and technical skill set
• Assist with continuous training of team members in accordance with legal developments and new products being offered
• 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 Claims Framework
• Manage claims portfolio(s) to optimise performance including regular review of individual claims and keeping reserves and records up to date
• Identify issues and trends in the portfolio and take corrective action as needed
• Ensure that all claim rejections are referred to Management for discussion before submission to Client
• Demonstrate thorough and sound application of policy knowledge to claims
• Display fair legal understanding in dealing with technically complex claims
• Deal with internal and external complaints (OSTI) and escalate accordingly
• Escalate problem claims to team leader, senior claims specialist and management as needed

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
• Provide input to underwriters on review of potential or existing insureds’ claims experience
• Provide feedback on claims trends and developments and their potential impact on the book; collaborate with marketing and underwriting regarding grey areas in policy wordings
• Authority and Minimum Standards Observance: Operate within your approved claims authority at all times and implement minimum operating and claim standards
• Have thorough knowledge of industry regulations and minimum standards to ensure compliance with 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 benefit Santam Marine claims
• Where required, conduct claim file reviews or audits and resolve 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
• Provide updates and follow-ups with Brokers and Surveyors
• Provide Loss Ratio Reports to Brokers when required
• Attend meetings with Relationship Managers when required; ensure the Claims Manager is included
• Claim Specialists and Claim Handlers should not attend 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

People Management

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

Client Liaison (Internal and External)

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

Qualifications and Experience

• Matric
• Post Graduate (optional)
• Minimum 3–5 years of actual marine specialist liability claims experience, including an understanding of facultative reinsurance 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. We are committed to transformation and growth and are expanding into emerging markets across Africa and Asia.

Santam serves a diverse client base and is committed to equal opportunity employment. We encourage applications from candidates of all backgrounds, including persons with disabilities.

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