Senior Claims Assessor - General Insurance

Placements24; Midrand; Hybrid; ZAR 700,000 - 900,000; Full time

Benefits offered by this job

Medical aid

Provident fund

Performance-based bonuses

Professional development

Employee wellness programs

Job summary

Placements24 is seeking a Senior Claims Assessor in Midrand to manage complex claims end-to-end, ensuring regulatory compliance and高 quality service to policyholders.

The role requires a strong understanding of insurance principles, excellent analytical and negotiation skills, and the ability to mentor junior staff while delivering accurate, timely outcomes in a fast-paced environment.

Qualifications

• Bachelor-level or higher qualification in Insurance, Law, Commerce or related field.
• Minimum 5 years of proven experience handling complex insurance claims.
• Solid knowledge of insurance principles, policy wordings and relevant legislation.
• Strong analytical, problem-solving and decision-making abilities.
• Excellent negotiation and communication skills, both written and verbal.
• Proficiency with claims management software and MS Office.
• Ability to work independently and in a team in a fast-paced environment.
• Experience mentoring or supervising junior staff is advantageous.

Responsibilities

• Investigate, evaluate and settle complex claims across motor, property and liability.
• Gather documentation, assess liability and damages.
• Communicate claim status and settlements to policyholders, claimants and legal reps.
• Maintain accurate claim files in the internal system.
• Provide guidance to junior claims assessors.
• Ensure compliance with legislation, standards and policies.
• Identify potential fraudulent claims and escalate when needed.
• Negotiate settlements within authorized limits.
• Prepare detailed reports on status, reserves and outcomes.
• Contribute to process improvements in claims handling.

Skills

Analytical thinking

Negotiation

Communication

Decision making

Mentorship (advantage)

Education

Tertiary qualification in Insurance/Law/Commerce

Tools

Claims management software

MS Office

Job description

About the Role

Our client, a leading insurance provider, is seeking a highly experienced and detail-oriented Senior Claims Assessor to join their dynamic team in Midrand, Gauteng . This pivotal role is responsible for managing complex insurance claims from initiation to resolution, ensuring adherence to company policies and regulatory requirements. The ideal candidate will possess a strong understanding of the insurance landscape, excellent analytical skills, and a commitment to providing exceptional service to policyholders during challenging times. This position offers a challenging yet rewarding opportunity to contribute to the operational excellence of a respected insurance entity. We are looking for individuals who are proactive, possess strong leadership potential, and are adept at navigating intricate claim scenarios. The successful candidate will play a crucial role in maintaining the integrity and efficiency of the claims department, fostering a culture of accuracy and prompt service delivery. This role is integral to upholding our client's reputation for reliability and customer satisfaction within the competitive South African insurance market. The role requires a keen eye for detail and the ability to interpret complex policy wordings and legal documentation accurately.

Key Responsibilities

• Investigate, evaluate, and settle complex insurance claims across various lines of business, including but not limited to motor, property, and liability.
• Conduct thorough investigations, gather necessary documentation, and assess liability and damages.
• Communicate effectively with policyholders, claimants, and legal representatives to explain claim status and settlement offers.
• Maintain accurate and up-to-date claim files in the internal system.
• Provide guidance and mentorship to junior claims assessors.
• Ensure compliance with all relevant legislation, industry standards, and company policies.
• Identify potential fraudulent claims and elevate accordingly.
• Negotiate settlements within authorized limits.
• Prepare detailed reports on claim status, reserves and outcomes.
• Contribute to the continuous improvement of claims handling processes and procedures.

Requirements

• A relevant tertiary qualification in Insurance, Law, Commerce, or a related field is preferred.
• A minimum of 5 years of proven experience in handling complex insurance claims, preferably within a similar South African context.
• Sound knowledge of insurance principles, policy wordings, and relevant legislation.
• Exceptional analytical, problem-solving, and decision-making skills.
• Strong negotiation and communication abilities, both written and verbal.
• Proficiency in claims management software and Microsoft Office Suite.
• Ability to work independently and as part of a team in a fast-paced environment.
• Demonstrated ability to manage a caseload effectively and meet deadlines.
• A professional demeanor and commitment to ethical conduct.
• Experience in mentoring or supervising junior staff is advantageous.

Benefits

Our client offers a competitive remuneration package commensurate with experience. This includes a comprehensive medical aid plan, a generous provident fund contribution, and performance-based bonuses. Opportunities for professional development and continuous learning are actively encouraged, including support for relevant industry certifications and further studies. A supportive and collaborative work environment fosters personal and professional growth. This role provides exposure to a wide range of complex claims, enhancing your expertise. Access to advanced training programs and workshops will be provided. Employees also benefit from employee wellness programs and a positive company culture focused on employee well-being and career advancement in Midrand, Gauteng .