76 Claims Processing jobs in South Africa

Team Lead: Claims Processing (Warranties)

Join TIH, home to some of South Africa’s leading financial service providers, and grow your career while being part of an organisation with purpose.

Job Purpose: Lead a team of Processing Claims Consultants to ensure the effective validation of already-captured claims. Ensure individual contributors are performing against targets, while reviewing their performance and coaching them to do so in order to assist in achieving the required operational targets.

• Leadership and Direction: Explain the local action plan to support team members in their understanding of what needs to be done and how this relates to the broader business plan and the organisation's strategy, mission and vision; motivate people to achieve local business goals.
• Performance Management: Respond to personal objectives and use performance management systems to improve personal performance. Monitor the performance of the team; allocate work and review completion, take appropriate corrective action to ensure timeliness and quality; contribute to formal individual performance management and appraisal.
• Operations Management: Supervise others working within established operational systems by ensuring quality decisions are made regarding the outcome of claims.
• Operational Compliance: Identify within the team instances of non-compliance with the organisation's policies and procedures and/or relevant regulatory codes and codes of conduct, reporting these and escalating issues as appropriate.
• Data Collection & Analysis: Collate and analyse claims processing data using pre-set tools, methods and formats. Involves working independently. This may involve identifying trends regarding the customer experience.
• Customer Management (Internal): Help senior colleagues manage client and customer relationships by using relevant client systems.
• Document Management: Create and ensure compliance with a company-wide document management system.
• Administration: Produce, update and provide best practice support on a wide range of MS documents, databases and other departmental systems to support the work of more senior colleagues.
• Correspondence: Respond to escalated requests using telephonic conversation or emails (internal and external).

• Matric / Grade 12 or SAQA Accredited Equivalent (Essential)
• Financial Sector Conduct Authority (FSCA) competency requirements: FAIS recognized qualifications / Regulatory Examinations / Class of Business Certification and / or CPD according to your DOFA where applicable (Advantageous)
• A relevant 3-year business related degree / diploma (Advantageous)

• 3 or more years Financial Services industry experience within a call centre environment (Essential)
• STI experience (Essential)
• 2 or more years Claims Experience (Essential)
• 1 or more years experience of supervising and directing people and other resources to achieve specific end results (Essential)

If you think you have what it takes to be part of an unstoppable team, apply now.

Overview

Job title : Claims Processing Consultant (Cape Town)

Job Location : Western Cape, Cape Town

Deadline : September 26, 2025

• Customer Management (Internal) - Help manage customer by carrying out standard activities to complete the customer request.
• Data Collection & Analysis - Ask questions, collect data from a variety of sources, analyse information and investigate claim.
• Work Scheduling and operational compliance - Organise own work schedule in order to get the job done, coordinating with support services and completed work within SLA.
• Administration - Produce, update and provide best practice support to customers on the claims administration process and other departmental systems, in line with claims policy, rules and SLAs.
• Correspondence - Respond to routine requests using telephonic conversation or emails (internal and external).
• Document Management - Create, organise and maintain files containing the correspondence relating to policies and matters.
• Document Preparation - Prepare and manage claim documentation for customers.
• Up-sell Customer Propositions - Identify a selection of products or services that may meet the customer's requirements, explain the product / service features to influence the customer to add additional

• Matric / Grade 12 or SAQA Accredited Equivalent (Essential); Regulatory Exam 5, dependent on DOFA date (Essential); Full 150 STI credits, dependent on DOFA date (Essential); CPD hours (Essential); Class of Business Certificate (Advantageous); Degree and / or diploma in business / marketing (Advantageous)

Overview

Claims Examiner - Third Party role at AIG.

• Receive approaches from uninsured and insured third parties, acknowledge receipt.
• Register and validate third party only claims.
• Assess and confirm merits of the claims.
• Request quantum/outstanding documents from the third party if applicable.
• Decide if claim is payable based on documentation provided.
• Appoint assessor based on claim specification.
• Provide updates to third party and insured/broker.
• Review assessment and draft offer for third party; negotiate a fair offer with the third party; send offer and facilitate settlement of signed offer; close files once settled.
• Record savings on spreadsheet.
• Maintain relationship with assessors, other insurers and broker/insureds.
• (Litigation) Receive summons and acknowledge receipt; verify legitimacy of claim; review summons and decide on action; appoint attorney based on summons specification; provide attorney with instruction and documents; follow up with attorney; guide attorney on acceptable offer and parameters of negotiating; settle attorney fees based on acceptable fee scale; negotiate with attorneys on fees based on settlements; maintain relationship with attorneys and investigators.

• Negotiation Skills
• Conflict resolution skills
• Math Skills
• Good Communication Skills
• Interpersonal Skills

At AIG, we value in-person collaboration as a vital part of our culture, which is why we ask our team members to be primarily in the office. This approach helps us work together effectively and create a supportive, connected environment for our team and clients alike.

Enjoy Benefits That Take Care Of What Matters. Our Total Rewards Program is a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on health, wellbeing and financial security—as well as professional development—to bring peace of mind to you and your family.

American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world’s most far-reaching property casualty networks. We are thinking in new and innovative ways to deliver better solutions to our customers. We invest in our people through continuous learning and development, in a culture that celebrates everyone for who they are and what they want to become.

We are committed to creating a culture that respects and celebrates each other’s talents, backgrounds, cultures, opinions and goals. We foster inclusion and belonging through learning and cultural awareness activities and Employee Resource Groups (ERGs) with global chapters. AIG provides equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories. We are committed to providing reasonable accommodations to job applicants and employees with disabilities. If you need a reasonable accommodation, please email Preference will be given to previously disadvantaged candidates in line with the Employment Equity Plan.

Functional Area: CL - Claims

Location: Johannesburg, South Africa

Responsibilities

• Receive approaches from uninsured and insured third parties, acknowledge receipt.
• Register and validate third party only claims.
• Assess and confirm merits of the claims.
• Request quantum/outstanding documents from the third party if applicable.
• Decide if claim is payable based on documentation provided.
• Appoint assessor based on claim specification.
• Provide updates to third party and insured/broker.
• Review assessment and draft offer for third party.
• Negotiate fair offer with third party.
• Send offer and facilitate settlement of signed offer.
• Close files once settled.
• Record savings on spreadsheet.
• Maintain relationship with assessors, other insurers and broker/insureds.
• (Litigation) Receive Summons and acknowledge receipt.
• Verify legitimacy of claim.
• Review summons and decide on action.
• Appoint attorney based on summon’s specification.
• Provide attorney with instruction and documents.
• Follow up with attorney.
• Guide attorney on acceptable offer and parameters of negotiating.
• Settle attorney fees based on acceptable fee scale.
• Negotiate with attorneys on fees based on settlements.
• Maintain relationship with attorneys and investigators.

• Negotiation Skills
• Conflict resolution skills
• Math Skills
• Good Communication Skills
• Interpersonal Skills

At AIG, we value in-person collaboration as a vital part of our culture, which is why we ask our team members to be primarily in the office. This approach helps us work together effectively and create a supportive, connected environment for our team and clients alike.

Enjoy benefits that take care of what matters

At AIG, our people are our greatest asset. We know how important it is to protect and invest in what’s most important to you. That is why we created our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security—as well as your professional development—to bring peace of mind to you and your family.

Reimagining insurance to make a bigger difference to the world

American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world’s most far-reaching property casualty networks. It is an exciting time to join us — across our operations, we are thinking in new and innovative ways to deliver ever-better solutions to our customers. At AIG, you can go further to support individuals, businesses, and communities, helping them to manage risk, respond to times of uncertainty and discover new potential. We invest in our largest asset, our people, through continuous learning and development, in a culture that celebrates everyone for who they are and what they want to become.

Welcome to a culture of inclusion

We’re committed to creating a culture that truly respects and celebrates each other’s talents, backgrounds, cultures, opinions and goals. We foster a culture of inclusion and belonging through learning, cultural awareness activities and Employee Resource Groups (ERGs). With global chapters, ERGs are a cornerstone for our culture of inclusion. The talent of our people is one of AIG’s greatest assets, and we are honored that our drive for positive change has been recognized by numerous recent awards and accreditations.

AIG provides equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories.

AIG is committed to working with and providing reasonable accommodations to job applicants and employees with disabilities. If you believe you need a reasonable accommodation, please send an email to

Preference will be given to previously disadvantaged candidates in line with the company’s Employment Equity Plan. Specific preference will be given to people with disabilities.

Functional Area: CL - Claims AIG South Africa

Are you a meticulous individual with a knack for managing commercial claims efficiently? Our globally recognised client in Randpark Ridge is looking for a skilled Claims Analyst to spearhead interactions with clients, brokers, and insurers, ensuring seamless processing and resolution of claims. Please apply if you have at least 3 years' experience with the full life cycle of claims.

• Handle claims as per delegated claims portfolio from cradle to grave.
• Daily Administration – Registering of new claims and ensuring that cover is in place and the correct excess is applied.
• On-going daily administration – all documents are timeously and accurately saved to the correct claim or policy file, as well as updating main statuses and additional statuses throughout the life cycle of the claim.
• Estimates are to be added correctly and updated throughout the claim life cycle, referring to the “maximum probable loss” theory.
• Liaising with the claims manager to establish your claims allocation and priority claims to be attended to.
• Maintain and manage the outstanding claims list to acceptable levels and with the focus on finalising claims faster and with the necessary broker satisfaction.
• Handling of broker telephone and email queries to limit broker complaints.
• Manage all relevant and expected communication to internal stakeholders within the agreed Service Level Agreement (SLA) or treaty requirements.
• Ensure that claims are finalized within agreed SLA period.
• Determine merit, investigation and determine whether external service providers are required.
• Assess claims by reviewing field reports, assessments and/or digital images or document received.
• Proactive identification of fraudulent cases and recovery potential and acting upon the identification in a pro-active manner.
• Proactive identification of salvage potential and acting upon the identification in a pro-active manner.
• Understands legal liability considerations in given claims.
• Decide on settlement recommendation or refer to the Claims Manager.
• Liaise with internal stakeholders, e.g. Underwriting, Assessing and Legal for Policy interpretation issues.
• Pro-actively manage broker expectation and ensure that all communication to brokers are completed timeously and accurately.
• You are responsible for all claims reporting to holding company and managed within the required treaty specifications.
• Ensure that payments are raised correctly and accurately to the correct beneficiary.
• All new beneficiaries receive the Beneficiary Form for completion.
• Completed beneficiary forms and BEE Certificates are correctly saved within the Compliance folder.
• Self-manage and complete allocated/ received emails and diaries on a daily basis.
• If the claim falls within your portfolio, ensure that any and all correspondence is saved to the file timeously and accurately. This includes emails that may have been sent by another member of staff.
• Daily statistics are sent to the line manager at the end of each day.

• Completed Matric.
• Completed RE5 Regulatory Examination.
• At least 3 years’ experience in claims.
• Own transport and valid licence.
• Clear criminal and credit checks.
• Reliable individual with sober habits.

R 25 000 - R 30 000 - Monthly

Are you a meticulous individual with a knack for managing commercial claims efficiently? Our globally recognised client in Randpark Ridge is looking for a skilled Claims Analyst to spearhead interactions with clients, brokers, and insurers, ensuring seamless processing and resolution of claims. Please apply if you have at least 3 years' experience with the full life cycle of claims.

1. Handle claims as per delegated claims portfolio from cradle to grave.
2. Daily Administration – Registering of new claims and ensuring that cover is in place and the correct excess is applied.
3. On-going daily administration – all documents are timeously and accurately saved to the correct claim or policy file, as well as updating main statuses and additional statuses throughout the life cycle of the claim.
4. Estimates are to be added correctly and updated throughout the claim life cycle, referring to the “maximum probable loss” theory.
5. Liaising with the claims manager to establish your claims allocation and priority claims to be attended to.
6. Maintain and manage the outstanding claims list to acceptable levels and with the focus on finalising claims faster and with the necessary broker satisfaction.
7. Handling of broker telephone and email queries to limit broker complaints.
8. Manage all relevant and expected communication to internal stakeholders within the agreed Service Level Agreement (SLA) or treaty requirements.
9. Ensure that claims are finalized within agreed SLA period.
10. Determine merit, investigation and determine whether external service providers are required.
11. Assess claims by reviewing field reports, assessments and/or digital images or document received.
12. Proactive identification of fraudulent cases and recovery potential and acting upon the identification in a pro-active manner.
13. Proactive identification of salvage potential and acting upon the identification in a pro-active manner.
14. Understands legal liability considerations in given claims.
15. Decide on settlement recommendation or refer to the Claims Manager.
16. Liaise with internal stakeholders, e.g. Underwriting, Assessing and Legal for Policy interpretation issues.
17. Pro-actively manage broker expectation and ensure that all communication to brokers are completed timeously and accurately.
18. You are responsible for all claims reporting to holding company and managed within the required treaty specifications.
19. Ensure that payments are raised correctly and accurately to the correct beneficiary.
20. All new beneficiaries receive the Beneficiary Form for completion.
21. Completed beneficiary forms and BEE Certificates are correctly saved within the Compliance folder.
22. Self-manage and complete allocated/ received emails and diaries on a daily basis.
23. If the claim falls within your portfolio, ensure that any and all correspondence is saved to the file timeously and accurately. This includes emails that may have been sent by another member of staff.
24. Daily statistics are sent to the line manager at the end of each day.

• Completed Matric.
• Completed RE5 Regulatory Examination.
• At least 3 years’ experience in claims.
• Own transport and valid licence.
• Clear criminal and credit checks.
• Reliable individual with sober habits.

R 25 000 - R 30 000 - Monthly

Senior Short Term Insurance Claims Handler with minimum 3 years’ Personal Lines and Commercial Claims experience in senior capacity and with the required NQF4 and RE5 Certifications, required to join this Broker Firm based in Bellville, Cape Town.

Minimum requirements:

• Matric essential
• NQF4 Short Term Insurance minimum
• RE5 essential
• Minimum 3 years’ claims handling experience in Personal Lines and Commercial Insurance in a senior role required
• Flexi, Cardinal and or CIMS 360 preferred

Duties and Responsibilities:

• Oversee negotiation and settlement of claims across Personal & Commercial lines
• Claims registration
• Claims management
• Negotiate settlements
• Communication with all stakeholders
• Complaints
• Evaluate and improve claims processes