Insurance Claims Adjuster

Placements24; Kempton Park; On-site; ZAR 300,000 - 420,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Provident fund

Company vehicle

Fuel allowance

Training & development

Career progression

Employee assistance

Job summary

Placements24 in Gauteng invites an Insurance Claims Adjuster to join our client’s expanding team in Tembisa. You will investigate claims, assess coverage, negotiate settlements, and process payments while upholding policy terms and regulatory standards.

The role requires 3–5 years of claims experience, a related diploma or degree, strong investigative and communication skills, and a valid driver's license to travel within the Gauteng area.

Qualifications

• Diploma or degree in Law, Business Admin, or Risk Mgmt
• 3–5 years of claims experience
• Knowledge of insurance policies and laws
• Strong investigative, analytical, and negotiation skills
• Proficient in claims software and MS Office
• Valid driver''s license; willingness to travel in Gauteng

Responsibilities

• Investigate claims by gathering information and interviewing witnesses
• Assess damage and determine policy coverage
• Negotiate settlements and prepare detailed reports
• Ensure compliance with laws and procedures
• Manage caseload and maintain accurate claim files
• Liaise with legal counsel, medical professionals, and experts
• Provide exceptional customer service throughout the claims process
• Identify potential fraud and escalate when needed

Skills

Investigative skills

Analytical abilities

Negotiation

Communication

MS Office

Claims software

Time management

Customer service

Travel readiness

Education

Related diploma/degree (Law, Business Admin, Risk Mgmt)

Tools

Claims management software

MS Office

Job description

About the Role Our client is seeking a dedicated and detail-oriented Insurance Claims Adjuster to join their expanding team in Tembisa, Gauteng . This role is pivotal in managing and resolving insurance claims efficiently and effectively, ensuring customer satisfaction while adhering to company policies and regulatory standards. The successful candidate will be responsible for investigating claims, determining liability, negotiating settlements, and processing payments. This is an excellent opportunity for an individual with strong investigative skills and a passion for customer service within the insurance industry. We are looking for a proactive individual who can handle a diverse caseload and make sound judgments under pressure. The position requires regular interaction with policyholders, witnesses, and other parties involved in a claim, necessitating excellent communication and interpersonal abilities. You will play a crucial role in upholding the company's reputation for fairness and efficiency in claims handling.

Key Responsibilities

• Investigate insurance claims by gathering information, interviewing witnesses, and examining policy details.
• Assess the extent of damage or loss and determine the coverage provided by the policy.
• Calculate and negotiate fair settlement amounts with policyholders and their representatives.
• Prepare detailed reports on claim investigations, findings, and recommendations.
• Ensure compliance with all applicable laws, regulations, and company procedures.
• Manage a caseload of claims, prioritizing tasks and meeting deadlines.
• Maintain accurate and up-to-date claim files in the company's system.
• Liaise with legal counsel, medical professionals, and other experts when necessary.
• Provide exceptional customer service throughout the claims process.
• Identify potential fraudulent claims and escalation them for further investigation.

Requirements

• A relevant diploma or degree in a related field (e.g., Law, Business Administration, Risk Management).
• Minimum of 3-5 years of experience as a Claims Adjuster or in a similar claims handling role.
• Sound knowledge of insurance policies, claims procedures, and relevant legislation.
• Excellent investigative, analytical, and problem-solving skills.
• Strong negotiation and communication abilities, both written and verbal.
• Proficiency in claims management software and Microsoft Office Suite.
• Ability to work independently and manage time effectively.
• Customer-focused with a high level of empathy and professionalism.
• Valid driver's license and willingness to travel within the Tembisa, Gauteng area as required.
• Integrity and a strong ethical compass in handling sensitive information.

Benefits

• Competitive salary package and performance-based incentives.
• Comprehensive medical and dental insurance coverage.
• Contribution to a provident fund.
• Opportunities for further training and professional development in claims management.
• A supportive team environment and clear career progression pathways.
• Company-provided vehicle and fuel allowance for fieldwork.
• Access to advanced claims processing technology.
• Employee assistance program for personal well-being.
• Annual performance reviews with potential for salary increases.
• Recognition programs for outstanding performance.