Senior Claims Assessor - Insurance

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

Benefits offered by this job

Hybrid work model

Medical aid

Retirement fund contributions

Professional development

Generous leave

Job summary

Placements24 is assisting a leading insurer in Paarl, Western Cape, ZA, to recruit a Senior Claims Assessor. You will lead complex claim evaluations, mentor junior staff, and shape claims handling procedures within a hybrid work setup.

The role requires 5+ years of claims experience, strong analytical and communication skills, and thorough knowledge of SA insurance regulations. Join a reputable firm with growth opportunities.

Qualifications

• A relevant tertiary qualification in Commerce, Law, or a related field is preferred.
• Minimum of 5 years of proven experience handling diverse insurance claims.
• Strong knowledge of South Africa insurance principles, regulations and legislation.

Responsibilities

• Investigate, evaluate and settle complex insurance claims in line with policy terms.
• Review claim documents, evidence and support materials thoroughly.
• Determine coverage, liability and accurate settlement amounts.
• Mentor junior claims assessors and share best practices in claims handling.

Skills

Analytical skills

Communication

Negotiation

Mentoring

Education

Commerce or Law degree

Tools

Claims management software

Job description

About the Role

Our client, a leading provider in the insurance sector, is seeking a highly experienced and diligent Senior Claims Assessor to join their dynamic team in Paarl, Western Cape, ZA. This role is pivotal in ensuring the efficient and accurate processing of insurance claims, upholding the company's commitment to exceptional customer service and financial integrity. The successful candidate will play a crucial role in mentoring junior staff and contributing to the strategic development of claims handling procedures. We are looking for an individual with a keen eye for detail, strong analytical skills, and a deep understanding of insurance policies and regulations. This position offers a fantastic opportunity to grow within a reputable organization and make a significant impact.

Key Responsibilities

• Investigate, evaluate, and settle complex insurance claims in accordance with policy terms and conditions.
• Conduct thorough reviews of claim documentation, evidence, and supporting materials.
• Determine coverage, liability, and settlement amounts accurately and promptly.
• Communicate effectively with policyholders, claimants, legal representatives, and other stakeholders.
• Identify potential fraud and escalatE suspicious cases for further investigation.
• Provide expert guidance and mentorship to junior claims assessors.
• Contribute to the development and implementation of best practices in claims management.
• Maintain detailed and accurate records of all claim activities.
• Ensure compliance with all relevant legislation and company policies.

Requirements

• A relevant tertiary qualification in Commerce, Law, or a related field is preferred.
• A minimum of 5 years of proven experience in handling diverse insurance claims (e.g., Personal Lines, Commercial Lines).
• In-depth knowledge of insurance principles, practices, and relevant legislation in South Africa.
• Strong analytical, problem-solving, and decision-making abilities.
• Excellent communication, negotiation, and interpersonal skills.
• Proficiency in claims management software and standard office applications.
• Ability to work independently and as part of a team in a hybrid work environment.
• A proactive approach to continuous learning and professional development.
• Demonstrated leadership potential or experience in mentoring.

Benefits

• Competitive annual salary commensurate with experience.
• Hybrid work model offering flexibility between home and office.
• Comprehensive medical aid and retirement fund contributions.
• Opportunities for professional development and career advancement.
• Generous leave allowance.
• A supportive and collaborative work environment in Paarl.
• Access to ongoing training and industry certifications.