Senior Complex Claims Adjuster – High-Value & Litigated

Placements24; South Africa; Remote; ZAR 900,000 - 1,200,000; Full time

Benefits offered by this job

Medical aid

Retirement plan

Life insurance

Career progression

Professional development

Job summary

Placements24 is seeking a seasoned Complex Claims Adjuster for our client, a leading insurance firm, based in Centurion, Gauteng. The role demands analytical prowess to handle high-value, multifaceted claims, with responsibilities spanning investigation, coverage review and settlement decisions.

You will negotiate, manage reserves, and stay abreast of regulatory changes while liaising with policyholders and legal representatives.

Qualifications

• 6+ years of experience handling complex insurance claims.
• Strong analytical, critical thinking and problem-solving skills.
• Superior negotiation and interpersonal abilities.
• Understanding of insurance principles, contracts and claims investigation.
• Litigation management experience is advantageous.
• Bachelor's degree or industry qualification preferred.

Responsibilities

• Investigate, evaluate and negotiate settlement of complex and potentially litigated insurance claims.
• Review policy wordings, endorsements and documentation to determine coverage.
• Gather and analyze evidence including witness statements and expert reports.
• Communicate effectively with policyholders, claimants, legal representations and stakeholders.
• Determine liability and indemnity, ensuring fair claim valuations.
• Approve payments and manage claim reserves efficiently.
• Identify subrogation and salvage opportunities.
• Maintain detailed claim files in line with procedures and audits.
• Stay updated on legal decisions and industry trends affecting claims.
• Provide expert advice to internal teams and external parties on complex claims.

Education

Bachelor's degree

Industry qualification

Tools

Claims software

Microsoft Office

Job description

Placements24 is seeking a seasoned Complex Claims Adjuster for our client, a leading insurance firm, based in Centurion, Gauteng. The role demands analytical prowess to handle high-value, multifaceted claims, with responsibilities spanning investigation, coverage review and settlement decisions.

You will negotiate, manage reserves, and stay abreast of regulatory changes while liaising with policyholders and legal representatives.