Senior Claims Assessor

Placements24; Midrand; Hybrid; ZAR 600,000 - 900,000; Full time

Benefits offered by this job

Medical aid

Retirement fund

Hybrid work model

Career development

Job summary

Placements24 is seeking a Senior Claims Assessor to join their insurance team in Midrand. The role focuses on investigating and adjudicating complex claims, ensuring policy and regulatory compliance, and guiding junior assessors.

The candidate will handle a diverse caseload, maintain detailed records, and collaborate with legal counsel and repair services to close claims efficiently. A strong background in SA insurance practices is essential.

Qualifications

• Minimum of 5 years experience in claims assessment in insurance.
• In-depth knowledge of various insurance products, policy wordings and SA legislation.
• Strong analytical, problem-solving and decision-making abilities.

Responsibilities

• Investigate, evaluate, and process complex insurance claims from initiation to settlement.
• Review claim documentation, gather evidence, and liaise with policyholders and witnesses.
• Interpret policies, identify coverage issues, and determine claim validity and settlement amounts.
• Provide mentorship to junior claims assessors and support professional development.
• Collaborate with internal departments and external stakeholders to resolve claims efficiently.
• Maintain accurate records of all claim activities in the system.

Skills

5+ years exp

Insurance knowledge

Analytical skills

Communication skills

Negotiation

Interpersonal skills

Education

Tertiary qualification in insurance, law or related

Job description

About the Role

Our client is seeking an experienced and detail-oriented Senior Claims Assessor to join their dynamic insurance team based in Midrand . This pivotal role involves thoroughly investigating and adjudicating complex insurance claims, ensuring compliance with policy terms, regulatory requirements, and company standards. You will be instrumental in providing expert guidance to junior assessors and contributing to the continuous improvement of claims handling processes within a challenging yet rewarding environment. The ideal candidate possesses a deep understanding of insurance principles and a proven track record in managing a diverse caseload efficiently and fairly.

Key Responsibilities

• Investigate, evaluate, and process complex insurance claims from initiation to settlement, ensuring accuracy and adherence to policy conditions.
• Conduct detailed reviews of claim documentation, gather necessary evidence, and liaise with policyholders, witnesses, and other relevant parties.
• Interpret insurance policies, identify coverage issues, and determine claim validity and appropriate settlement amounts.
• Provide mentorship and technical guidance to junior claims assessors, fostering their professional development and ensuring consistent service quality.
• Collaborate with internal departments and external stakeholders, such as legal counsel and repair services, to facilitate efficient claim resolution.
• Maintain accurate and comprehensive records of all claim activities and decisions within the claims management system.

Requirements

• Minimum of 5 years of experience in claims assessment within the insurance industry.
• A relevant tertiary qualification in insurance, law, or a related field is highly desirable.
• In-depth knowledge of various insurance products, policy wordings, and relevant legislation in South Africa .
• Strong analytical, problem-solving, and decision-making skills with a keen eye for detail.
• Excellent communication, negotiation, and interpersonal skills, with the ability to handle sensitive situations professionally.

Benefits

• Competitive annual salary package commensurate with experience.
• Opportunities for professional development and career advancement within the insurance sector.
• Access to a comprehensive medical aid scheme and retirement fund.
• A hybrid work model offering flexibility between office and remote work.
• A supportive team environment that values collaboration and expertise in Midrand .