Senior Claims Assessor - Personal Lines

Placements24; Pietermaritzburg; Hybrid; ZAR 420,000 - 660,000; Full time

Benefits offered by this job

Medical aid

Retirement fund contributions

Professional development

Hybrid work arrangements

Job summary

Placements24 is seeking a Senior Claims Assessor for a leading insurer in Pietermaritzburg. You will manage complex personal lines claims from inception to settlement, ensuring fair resolutions and regulatory compliance.

The role requires strong analytical and negotiation skills, in-depth knowledge of the South African market, and the ability to mentor junior assessors. A relevant tertiary qualification is preferred, with potential KwaZulu-Natal travel.

Qualifications

• Minimum 5 years of experience in personal lines claims assessment.
• Deep understanding of SA insurance market and regulations.
• Strong analytical, negotiation and communication skills.

Responsibilities

• Investigate, assess, and adjudicate personal lines insurance claims accurately and efficiently.
• Interpret policy wordings, conditions, and exclusions to determine coverage.
• Communicate effectively with policyholders, brokers, and third parties throughout the claims process.
• Negotiate settlements within prescribed authority limits.
• Identify potential fraud and escalate suspicious claims for further investigation.
• Maintain accurate and up-to-date claims files and documentation.
• Provide guidance and mentorship to junior claims assessors.
• Contribute to process improvement initiatives within the claims department.
• Ensure compliance with all relevant legislation and company policies.

Skills

Personal lines claims assessment

Analytical thinking

Negotiation

Communication

Claims software

MS Office

Education

Tertiary qualification in Insurance/Law

Tools

Claims management software

MS Office

Job description

About the Role

Our client, a leading insurance provider, is seeking a highly experienced Senior Claims Assessor to join their dynamic team in Pietermaritzburg . This pivotal role involves managing complex personal lines claims from inception to settlement, ensuring a fair and efficient resolution for policyholders. You will play a crucial part in upholding the company's reputation for excellent customer service and claims handling expertise. The ideal candidate will possess a deep understanding of insurance principles and regulations, coupled with strong analytical and negotiation skills. This is an excellent opportunity to advance your career within a reputable organisation that values professional growth and development. The role demands a proactive approach and the ability to work effectively under pressure.

Key Responsibilities

• Investigate, assess, and adjudicate personal lines insurance claims accurately and efficiently.
• Interpret policy wordings, conditions, and exclusions to determine coverage.
• Communicate effectively with policyholders, brokers, and third parties throughout the claims process.
• Negotiate settlements within prescribed authority limits.
• Identify potential fraud and escalate suspicious claims for further investigation.
• Maintain accurate and up-to-date claims files and documentation.
• Provide guidance and mentorship to junior claims assessors.
• Contribute to process improvement initiatives within the claims department.
• Ensure compliance with all relevant legislation and company policies.

Requirements

• A relevant tertiary qualification in Insurance, Law, or a related field is highly preferred.
• A minimum of 5 years of experience in personal lines claims assessment.
• Proven knowledge of the South African insurance market and regulatory environment.
• Excellent analytical, problem-solving, and decision-making skills.
• Strong negotiation and communication abilities, both written and verbal.
• Proficiency in claims management software and MS Office Suite.
• Ability to work independently and as part of a team.
• A valid driver's license and willingness to travel occasionally within KwaZulu-Natal may be required.

Benefits

• Our client offers a competitive salary package commensurate with experience, including performance-based bonuses.
• Employees benefit from comprehensive medical aid and retirement fund contributions.
• Opportunities for continuous professional development, including further certifications and training, are readily available.
• A supportive and collaborative work environment fosters career advancement.
• Additional perks include generous annual leave and potential for hybrid work arrangements, offering a flexible work-life balance.
• This role is based in the vibrant city of Pietermaritzburg , providing a great lifestyle balance.