Senior Insurance Claims Assessor - Personal Lines

Placements24; Johannesburg; Hybrid; ZAR 900,000 - 1,050,000; Full time

Benefits offered by this job

Medical aid

Provident fund

Hybrid work model

Performance bonuses

Career development opportunities

Job summary

Placements24 in Randburg, Gauteng, is seeking a Senior Claims Assessor for its personal lines team. The role involves leading complex claims, interpreting policy wordings, and guiding junior assessors to ensure fair settlements and regulatory compliance.

You should have at least six years in personal lines claims, ACII and RE5 qualifications, strong analytical and negotiation skills, and proven ability to manage a demanding workload in a hybrid work environment.

Qualifications

• Six+ years of experience in personal lines insurance claims.
• ACII and RE5 qualifications.
• Strong analytical, decision-making and problem-solving abilities.
• Excellent negotiation and communication skills with empathy.
• Proficiency in claims management systems.
• Ability to work independently and mentor others.

Responsibilities

• Investigate, evaluate, and settle complex personal insurance claims.
• Interpret policy wordings and assess coverage.
• Communicate with policyholders, brokers, and stakeholders regarding claim status and decisions.
• Negotiate settlements fairly and efficiently.
• Identify potential fraud indicators for further investigation.
• Mentor and provide guidance to junior claims assessors.
• Ensure claims handling is compliant with procedures and regulatory requirements.
• Maintain accurate and comprehensive claim files and documentation.
• Contribute to continuous improvement of claims processes and best practices.
• Collaborate with underwriting and legal on complex cases.

Skills

Analytical skills

Decision-making

Problem-solving

Negotiation

Communication

Leadership

Education

ACII

RE 5

Tools

Claims management systems

Job description

About the Role

Our client, a prominent insurance group, is seeking a highly experienced Senior Claims Assessor to join their personal lines department in Randburg, Gauteng . This senior role involves managing complex claims, providing expert guidance, and ensuring the efficient and fair resolution of claims for policyholders. You will be responsible for assessing a variety of personal insurance claims, including home, contents, and vehicle insurance, making critical decisions on coverage and settlement. The ideal candidate will possess extensive knowledge of personal insurance products, strong analytical skills, and exceptional customer service capabilities. This is a leadership opportunity within a dynamic and supportive team.

Key Responsibilities

• Investigate, evaluate, and settle complex personal insurance claims within delegated authority limits.
• Interpret policy wordings and assess coverage based on claim circumstances.
• Communicate effectively with policyholders, brokers, and other stakeholders regarding claim status and decisions.
• Negotiate settlements fairly and efficiently, ensuring client satisfaction.
• Identify and elevate potential fraud indicators for further investigation.
• Mentor and provide guidance to junior claims assessors.
• Ensure claims handling is conducted in line with company procedures and regulatory requirements.
• Maintain accurate and comprehensive claim files and documentation.
• Contribute to the continuous improvement of claims processes and best practices.
• Collaborate with other departments, such as underwriting and legal, on complex cases.

Requirements

• A minimum of 6 years of experience in personal lines insurance claims assessment.
• In-depth knowledge of personal insurance products (e.g., household, contents, motor, travel).
• Proven ability to manage complex claims with accuracy and efficiency.
• Strong analytical, decision-making, and problem-solving skills.
• Excellent negotiation and communication skills, with a high level of empathy.
• Proficiency in claims management systems and standard office software.
• Relevant insurance qualifications (e.g., ACII) and regulatory compliance (e.g., RE 5).
• Ability to work independently and manage a demanding workload.
• Demonstrated leadership potential or experience in mentoring others.
• A commitment to upholding the highest standards of ethical conduct.

Benefits

Our client offers a competitive salary package, including performance-related bonuses and comprehensive benefits such as medical aid and provident fund contributions. Excellent opportunities for professional development, ongoing training, and career progression are provided. This role is based in Randburg, Gauteng , and operates on a hybrid model, offering flexibility. Join a well-respected organization where your expertise will be valued, and you can make a significant impact on customer satisfaction and business success.