Senior Claims Assessor: Complex Claims, Growth in Gauteng

Placements24; Benoni; Hybrid; ZAR 520,000 - 740,000; Full time

Benefits offered by this job

Competitive salary

Medical aid and retirement fund

Professional development

Collaborative environment

Career advancement opportunities

Job summary

Placements24 is seeking a Senior Claims Assessor for a leading insurance provider in Benoni, Gauteng. This role focuses on meticulous evaluation, investigation, and settlement of complex property and casualty claims, requiring strong knowledge of policy wordings, legal frameworks, and risk assessment.

You will conduct investigations, assess validity, determine settlements, manage a caseload, liaise with legal counsel and loss adjusters, identify fraud, prepare reports, and mentor junior handlers

Qualifications

• A tertiary qualification in Insurance, Law, Business or related field is highly desirable.
• Minimum of 5 years of experience in claims assessing, specifically in property and casualty.
• In-depth knowledge of insurance legislation, policy wordings, and claims handling best practices in Gauteng.
• Excellent analytical, problem-solving, and decision-making skills.
• Strong negotiation and communication abilities, both written and verbal.
• Proficiency in using claims management software and standard office applications.

Responsibilities

• Conduct thorough investigations into insurance claims, gathering evidence, interviewing parties, and reviewing documentation.
• Assess the validity and scope of claims in line with policy terms and conditions.
• Determine appropriate settlement amounts, negotiating with policyholders and third parties where necessary.
• Manage a caseload of complex claims, ensuring timely resolution and SLA adherence.
• Liaise with legal counsel, loss adjusters, and other experts to facilitate the claims process.
• Identify potential fraudulent claims and implement investigation protocols.
• Prepare detailed reports and documentation for claims files and potential litigation.
• Provide guidance and support to junior claims handlers, promoting continuous improvement.

Skills

Analytical thinking

Negotiation

Communication skills

Problem solving

Independent & teamwork

Education

Tertiary qualification in Insurance, Law, or Business

Tools

Claims management software

Job description

Placements24 is seeking a Senior Claims Assessor for a leading insurance provider in Benoni, Gauteng. This role focuses on meticulous evaluation, investigation, and settlement of complex property and casualty claims, requiring strong knowledge of policy wordings, legal frameworks, and risk assessment.

You will conduct investigations, assess validity, determine settlements, manage a caseload, liaise with legal counsel and loss adjusters, identify fraud, prepare reports, and mentor junior handlers