Senior Claims Assessor - Comprehensive Insurance Solutions

Placements24; Midrand; Hybride; ZAR 700 000 - 900 000; Plein temps

Avantages offerts par ce poste

Competitive salary

Bonuses

Medical aid

Retirement fund

Résumé du poste

Placements24 is seeking a Senior Claims Assessor for our client in Midrand, Gauteng. The role focuses on managing complex insurance claims from initiation to settlement, ensuring policy terms and regulatory compliance are met.

You will investigate and adjudicate across multiple lines, gather supporting documentation, negotiate settlements, and mentor junior staff while staying abreast of regulatory changes and industry best practices.

Qualifications

• Minimum of 5 years of insurance claims assessment experience.
• Qualifications in Insurance, Law, Commerce, or related field.
• Professional designations (e.g., CIP) are advantageous.
• Strong knowledge of SA insurance principles and legislation.
• Proven negotiation and analytical skills.

Responsabilités

• Investigate, evaluate, and adjudicate complex insurance claims across multiple lines of business.
• Gather and analyse policy details, incident reports, expert opinions, and financial statements.
• Determine coverage, liability, and damages per policy provisions and legislation.
• Negotiate settlements with claimants and legal representatives.
• Manage claim reserves and update through the lifecycle.
• Prepare comprehensive claim reports for management review.
• Collaborate with underwriters, legal counsel, and support staff.
• Mentor junior claims assessors and promote learning.
• Identify potential fraud and escalate for investigation.
• Stay updated on industry trends and regulatory changes.

Connaissances

Analytical thinking

Negotiation

Communication

Problem-solving

Attention to detail

Team collaboration

Formation

Relevant tertiary qualification

CIP designation

Outils

Claims software

MS Office

Description du poste

About the Role

Our client, a leading innovator in the insurance sector, is seeking a highly skilled and experienced Senior Claims Assessor to join their dynamic team in Midrand, Gauteng. This pivotal role involves managing complex insurance claims from initiation to settlement, ensuring adherence to policy terms, regulatory requirements, and company standards. The ideal candidate will possess a deep understanding of various insurance products, excellent analytical abilities, and a commitment to providing exceptional customer service. This position offers a stimulating work environment within a company that values expertise and professional growth, with opportunities to influence claims handling procedures and mentor junior team members. The role requires a proactive approach to problem-solving and a keen eye for detail, ensuring fair and efficient outcomes for all parties involved.

Key Responsibilities

• Investigate, evaluate, and adjudicate complex insurance claims across multiple lines of business (e.g., property, casualty, motor).
• Gather and analyze all relevant documentation, including policy details, incident reports, expert opinions, and financial statements.
• Determine coverage, liability, and damages in accordance with policy provisions and applicable legislation.
• Negotiate settlements with claimants, legal representatives, and other involved parties in a professional and ethical manner.
• Manage claim reserves accurately and update them as necessary throughout the claim lifecycle.
• Prepare comprehensive claim reports, detailing findings, decisions, and recommendations for management review.
• Collaborate with underwriters, legal counsel, and claims support staff to ensure a cohesive approach to claim management.
• Mentor and provide guidance to junior claims assessors, fostering a culture of continuous learning and development.
• Identify potential fraudulent claims and escalation them for further investigation.
• Maintain up-to-date knowledge of industry trends, regulatory changes, and best practices in claims assessment.

Requirements

• Minimum of 5 years of experience in insurance claims assessment, with a proven track record in handling complex claims.
• Relevant tertiary qualification in Insurance, Law, Commerce, or a related field.
• Professional designations (e.g., CIP) are highly advantageous.
• In-depth knowledge of insurance principles, policy wordings, and relevant South African legislation.
• Strong analytical, critical thinking, and problem-solving skills.
• Excellent negotiation, communication (written and verbal), and interpersonal skills.
• Proficiency in claims management software and standard office applications.
• Ability to work independently and as part of a team in a fast-paced environment.
• Demonstrated commitment to ethical conduct and customer satisfaction.
• Experience in mentoring or supervising junior staff is a significant plus.

Benefits

• Competitive annual salary package commensurate with experience.
• Performance-based bonuses and incentives.
• Comprehensive medical aid and retirement fund contributions.
• Generous annual leave allowance.
• Opportunities for professional development, continuous training, and career advancement within the company.
• Access to state-of-the‑art facilities and technology.
• A supportive and collaborative work culture in Midrand, Gauteng.