Senior Insurance Claims Assessor - Personal Lines

Placements24; Randburg; Hybrid; ZAR 550,000 - 850,000; Full time

Benefits offered by this job

Medical aid

Provident fund

Professional development

Training opportunities

Job summary

Placements24 is seeking a Senior Claims Assessor for the personal lines team in Randburg, Gauteng. The role focuses on evaluating complex claims, guiding junior staff, and ensuring fair settlements within delegated authority.

The ideal candidate has extensive personal lines knowledge, strong analytical skills, and excellent negotiation and customer service abilities. Hybrid work setup available in Randburg.

Qualifications

• Minimum 6 years of experience in personal lines claims assessment.
• ACII qualification and RE 5 regulatory knowledge.
• Strong analytical, decision-making and problem-solving skills.
• Excellent negotiation and communication with high empathy.
• Ability to mentor junior assessors and lead claims handling.

Responsibilities

• Investigate, evaluate, and settle complex personal insurance claims within delegated authority.
• Interpret policy wordings and assess coverage based on the claim circumstances.
• Communicate effectively with policyholders, brokers, and stakeholders regarding claim status and decisions.
• Negotiate settlements fairly and efficiently, ensuring client satisfaction.
• Identify escalation indicators for potential fraud and initiate investigations.
• 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 underwriting and legal on complex cases.

Skills

Leadership

Analytical thinking

Negotiation

Communication

Mentoring

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 the 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 **escalate** 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.