32 Liability Claims jobs in South Africa

Main job function
Engineering & Liability claims negotiator

The duties of this position include but shall not be limited to the following:

Operational:
1. Attending to own damage claims, liability and SASRIA claims (amongst others) in respect of Plant All Risk, Contractors All Risk, Machinery Breakdown & Business Interruption and Electronic Equipment (where applicable);
2. Actively manage and oversee start to end of claims function.
3. Contribute to the growth and profitability of the Company by providing excellent service and maintaining relationships.
4. Manage and organize day to day operations by establishing priorities to ensure registering, handling and settling of claims on Company’s delegated authority and at the same time maintain the standards of the claims department.
5. Controlling of registers, compliance with SLA’s, diary management, quantum, recoveries, salvage and secure proper claims maintenance.
6. Assess the claims internally.
7. Ensure all technical aspects for claims settlement are adhered to.
8. Negotiate settlement of the claims with all relevant stakeholders.
9. Daily diary files to be extracted and dealt with e.g. letters of demand, final notices reminders and follow-up assessors’ reports.
10. Processing payments on system:
a. Registering claims with the reinsurers/co insurers companies.
b. Facultative reinsurance & co-insurance recoveries.
c. Monitor and periodically review estimates.
d. Appointment of investigators, assessors, loss adjusters and other experts if necessary.
11. Negotiate discounts to reduce costs with repairers, service providers and partners, without compromising quality or harming client retention initiatives.
12. Attend to Third party claims in terms of the Contractors Third Party Liability cover.
13. Signing off third-party releases; and
14. Third Party recoveries.

Relationship Management:
1. Liaising in a professional manner with brokers and other insurers in respect of claims aspects:
a. Following up on regular intervals and providing constructive feedback to brokers and management.
b. respond to queries within 24 hours.
2. Work with different people internally and externally to improve service, efficiency, and improve presentation of information.
3. Actively build, improve and maintain relationships with all stakeholders, i.e. internally and externally

A Consultant will be in touch if you are shortlisted for the position. Please consider your application unsuccessful should you not have been contacted within 2 weeks. We will keep your CV on our database and contact you should you match the criteria of any other vacancies.

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We have an exciting opportunity for the Claims Specialist within SHA Risk Specialists .

What will make you successful in this role?

Key responsibilities:

• Attend and manage all aspects related to a portfolio of specialist claims such as claims registration, case management, drafting, diary, recoveries, and settlement negotiations.
• Draft settlement agreements and other legal documents within mandate as per the Claims Governance Folder.
• Strategically manage a portfolio of claims.
• Manage loss adjusters and attorneys' appointments on matters and ensure compliance with agreed service level agreements.
• Monitor and manage legal spend of attorneys and loss adjusters.
• Manage system processing and compliance with systems by way of payments, updating signed reserves, and proper recordal of information.
• Attend to operational duties as allocated.
• Compile and manage risk reports when required.
• Actively manage and record claims above certain thresholds as per The Claims Governance Folder and report on matters to Claims Co and Executive where required.
• Ensure compliance with internal and external regulatory frameworks and organizational standards.
• Draft processes and procedures that are compliant with relevant legislation and regulatory frameworks.
• Effectively liaise and interact with Underwriters.

Analysis: Consider, analyze, and interpret insurance policies and their contractual impact for coverage determination. Critically analyze facts and their impact on the policy.

Draft opinions on coverage interpretation, merits, and quantum, supported by relevant caselaw and legislation. Apply critical thinking to ensure appropriate decisions on merits and policy responses.

Evaluate information provided, identify additional information required, and conduct strategic assessments of claims.

Develop an understanding of technical and legal aspects impacting policy operation.

Make recommendations for improved wording and trend identification to underwriters.

Engage in continuous training on case law and policy wording.

Assist in developing SOPs and processes for claims department effectiveness.

Create opportunities for interaction with brokers and insureds.

Client Liaison (Internal and External): Liaise with clients to resolve queries within scope of authority. Prepare for and attend meetings with brokers, insureds, legal representatives, and loss adjusters.

Skills and Competencies:

• Administrative Skills
• Analysis and Judgement
• Attention to Detail
• Client Orientation
• Communication Skills including Negotiation
• Follow Up
• Initiative
• Interpersonal Skills
• Organizational Awareness
• Planning and Organizing
• Teamwork
• Computer Literacy
• Ability to Strategize and Drive a Claim to Finality

Qualifications & Experience:

• Matric
• Law Degree
• Admitted Attorney
• FAIS Compliance (preferred)
• Previous non-motor liability claims handling experience

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We have an exciting opportunity for the Claims Specialist within SHA Risk Specialists.

Key responsibilities:

• Attend and manage all aspects related to a portfolio of specialist claims such as claims registration, case management, drafting, diary, recoveries, and settlement negotiations.
• Draft settlement agreements and other legal documents within mandate as per the Claims Governance Folder.
• Strategically manage a portfolio of claims.
• Manage loss adjusters and attorneys appointment on matters and ensure compliance with agreed service level agreements.
• Monitor and manage legal spend of attorneys and loss adjusters.
• Manage system processing and compliance with systems by way of payments, updating signed off reserves, proper recordal of information etc.
• Attend to Operational duties as allocated.
• Compile and manage risk reports when required.
• Actively manage and record claims above certain thresholds as per The Claims Governance Folder and report on matters to Claims Co and Executive where required.
• Comply with internal and external regulatory framework and internal and external processes and procedures in accordance with organisational standards.
• Draft processes and procedures that are compliant with relevant regulatory framework and applicable legislation.
• Effectively liaise and interact with Underwriters.

Analysis:

• Consider, analyse and interpret insurance policy and the contractual impact thereof for the determination of coverage;
• Critically analyse the facts of the matter and their impact on the underlying policy.
• Draft opinions on the interpretation of coverage in relation to the facts and the applicable policy, present and motivate;
• Draft opinions on merits and quantum of matter with the relevant caselaw and legislation applicable;
• Apply critical thinking to ensure appropriate decisions on merits, quantum and policy response.
• Critically consider and evaluate information provided and identify information required.
• Conduct a strategic assessment of claims and make strategic decisions and recommendations on handling of claims.
• Develop and maintain an understanding of technical and legal aspects impacting on the policy’s operation.
• Make representations and recommendations on improved wording and trends identification to underwriters.
• Be involved in continuous training and development in respect of Case Law, Policy wording, etc.
• Assist in identifying and developing SOP’s and processes to ensure claims department effectiveness.
• Take initiative in creating opportunities of interaction with Brokers and Insureds.

Client Liaison (Internal and External):

• Liaise with clients to resolve queries to the satisfaction of the affected parties within the scope of authority and / or responsibility.
• Prepare for and attend meetings and consultation with brokers, insureds, legal representatives and loss adjusters.

• Administrative Skills
• Analysis and Judgement
• Attention to Detail
• Client Orientation
• Communication Skills including negotiation
• Follow Up
• Initiative
• Interpersonal Skills
• Organisational Awareness
• Planning and Organising
• Teamwork
• Computer Literacy
• Ability to strategise and drive a claim to finality

• Matric
• Law Degree
• Admitted attorney
• FAIS compliance a preference
• Previous non-motor liability claims handling experience

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We have an exciting opportunity for the Claims Specialist within SHA Risk Specialists.

Key responsibilities:

• Attend and manage all aspects related to a portfolio of specialist claims such as claims registration, case management, drafting, diary, recoveries, and settlement negotiations.
• Draft settlement agreements and other legal documents within mandate as per the Claims Governance Folder.
• Strategically manage a portfolio of claims.
• Manage loss adjusters and attorneys appointment on matters and ensure compliance with agreed service level agreements.
• Monitor and manage legal spend of attorneys and loss adjusters.
• Manage system processing and compliance with systems by way of payments, updating signed off reserves, proper recordal of information etc.
• Attend to Operational duties as allocated.
• Compile and manage risk reports when required.
• Actively manage and record claims above certain thresholds as per The Claims Governance Folder and report on matters to Claims Co and Executive where required.
• Comply with internal and external regulatory framework and internal and external processes and procedures in accordance with organisational standards.
• Draft processes and procedures that are compliant with relevant regulatory framework and applicable legislation.
• Effectively liaise and interact with Underwriters.

Analysis:

• Consider, analyse and interpret insurance policy and the contractual impact thereof for the determination of coverage;
• Critically analyse the facts of the matter and their impact on the underlying policy.
• Draft opinions on the interpretation of coverage in relation to the facts and the applicable policy, present and motivate;
• Draft opinions on merits and quantum of matter with the relevant caselaw and legislation applicable;
• Apply critical thinking to ensure appropriate decisions on merits, quantum and policy response.
• Critically consider and evaluate information provided and identify information required.
• Conduct a strategic assessment of claims and make strategic decisions and recommendations on handling of claims.
• Develop and maintain an understanding of technical and legal aspects impacting on the policy’s operation.
• Make representations and recommendations on improved wording and trends identification to underwriters.
• Be involved in continuous training and development in respect of Case Law, Policy wording, etc.
• Assist in identifying and developing SOP’s and processes to ensure claims department effectiveness.
• Take initiative in creating opportunities of interaction with Brokers and Insureds.

Client Liaison (Internal and External):

• Liaise with clients to resolve queries to the satisfaction of the affected parties within the scope of authority and / or responsibility.
• Prepare for and attend meetings and consultation with brokers, insureds, legal representatives and loss adjusters.

• Administrative Skills
• Analysis and Judgement
• Attention to Detail
• Client Orientation
• Communication Skills including negotiation
• Follow Up
• Initiative
• Interpersonal Skills
• Organisational Awareness
• Planning and Organising
• Teamwork
• Computer Literacy
• Ability to strategise and drive a claim to finality

• Matric
• Law Degree
• Admitted attorney
• FAIS compliance a preference
• Previous non-motor liability claims handling experience

Salary: R 240,000 - R 280,000 Annually Cost To Company

The main purpose of the Claims Specialist’s role is to validate and administer a client’s claim following a fortuitous event. The claims specialist will be responsible for various Non-Motor Claims. Claims settlement determinations are made in accordance with Standard Operating Procedures, claims guidelines, the specialist's own mandate, and the client’s policy schedule.

1. Matric Certificate – essential
2. RE – highly advantageous
3. Higher Certificate in Short Term Insurance - NQF 5 or Full Qualification NQF 4 – highly advantageous
4. Must be compliant with FAIS Fit and Proper requirements with a track record of working unsupervised
5. Computer literate – Microsoft Word, Excel, and Outlook
6. Experience working on the TIAL Operating System (System A) – highly advantageous
7. 1-2 Years relevant work experience in claims validations and settlement
8. Exposure to short-term insurance claims administration – highly advantageous

Please note that only shortlisted candidates will be contacted.

Salary: R 240,000 - R 280,000 Annually Cost To Company

The main purpose of the Claims Specialist’s role is to validate and administer a client’s claim following a fortuitous event. The claims specialist will be responsible for various Non-Motor Claims. Claims settlement determinations are made in accordance with Standard Operating Procedures, claims guidelines, the specialist's own mandate, and the client’s policy schedule.

1. Matric Certificate – essential
2. RE – highly advantageous
3. Higher Certificate in Short Term Insurance - NQF 5 or Full Qualification NQF 4 – highly advantageous
4. Must be compliant with FAIS Fit and Proper requirements with a track record of working unsupervised
5. Computer literate – Microsoft Word, Excel, and Outlook
6. Experience working on the TIAL Operating System (System A) – highly advantageous
7. 1-2 Years relevant work experience in claims validations and settlement
8. Exposure to short-term insurance claims administration – highly advantageous

Please note that only shortlisted candidates will be contacted.

R 3000 - R 36000 Annually Cost To Company

The main purpose of the Claims Specialist’s role is to validate and process short-term insurance claims following a fortuitous event. Working in close partnership with an allocated portfolio of brokers, the Binder and Outsource Claims Specialist will specifically make claims validation decisions on complex and high value claims that exceed the broker’s mandate (for both Motor and Non-Motor, Personal Lines and Commercial Lines).

The Claims specialist will also fulfill a coaching role, assisting and guiding binder and outsource brokers to make correct claims validation determinations on all claims that fall within their defined mandate.

The Claims Specialist will oversee the training and oversight of the binder and outsource brokers

Key Performance Areas:

• Validation of claims in line with Company guidelines and Standard Operating Procedures
• Management of Large loss and complex claims
• Appointment of necessary providers
• AuthorizationsSettlement of claims
• Rejection of claims
• Processing payments within the turn-around time
• Payment confirmations to Brokers and Suppliers
• Assisting clients and brokers over the phone / email with claims and queries
• Relationship Management with allocated brokers, including training of brokers with binder and outsource
  agreements
• Oversight and management of binder and outsource brokers
• Complaints handling and resolution
• Liaising with Service Providers
• Liaising with brokers and clients

• Matric Certificate – essential
• Regulatory Exam
• Further Education and Training Certificate in Short-Term Insurance – NQF 4, and/ or a Higher Certificate in
  Short term Insurance - NQF 5
• Class of Business certification (Personal Lines & Commercial Lines) – Highly advantageous
• Must be compliant with FAIS Fit and Proper requirements with track-record of working unsupervised.
• Marine and Engineering knowledge – Highly advantageous
• Computer literate – Microsoft Word, Excel, and Outlook
• Experience in Commercial and Personal lines
• At least 5-years’ relevant work experience in claims validations and settlement (both in Motor and NonMotor claims, as well as in both Personal Lines and Commercial Lines classes of business)
• Work experience within a licensed insurer, or Underwriting Manager.
• Experienced in making claims settlement determinations with mandate exceeding R250 000.00
• Sound technical knowledge and understanding of relevant short term insurance policy wording

R 3000 - R 36000 Annually Cost To Company

The main purpose of the Claims Specialist’s role is to validate and process short-term insurance claims following a fortuitous event. Working in close partnership with an allocated portfolio of brokers, the Binder and Outsource Claims Specialist will specifically make claims validation decisions on complex and high value claims that exceed the broker’s mandate (for both Motor and Non-Motor, Personal Lines and Commercial Lines). The Claims specialist will also fulfill a coaching role, assisting and guiding binder and outsource brokers to make correct claims validation determinations on all claims that fall within their defined mandate. The Claims Specialist will oversee the training and oversight of the binder and outsource brokers

Key Performance Areas:

• Validation of claims in line with Company guidelines and Standard Operating Procedures
• Management of Large loss and complex claims
• Appointment of necessary providers
• AuthorizationsSettlement of claims
• Rejection of claims
• Processing payments within the turn-around time
• Payment confirmations to Brokers and Suppliers
• Assisting clients and brokers over the phone / email with claims and queries
• Relationship Management with allocated brokers, including training of brokers with binder and outsource
  agreements
• Oversight and management of binder and outsource brokers
• Complaints handling and resolution
• Liaising with Service Providers
• Liaising with brokers and clients

• Matric Certificate – essential
• Regulatory Exam
• Further Education and Training Certificate in Short-Term Insurance – NQF 4, and/ or a Higher Certificate in
  Short term Insurance - NQF 5
• Class of Business certification (Personal Lines & Commercial Lines) – Highly advantageous
• Must be compliant with FAIS Fit and Proper requirements with track-record of working unsupervised.
• Marine and Engineering knowledge – Highly advantageous
• Computer literate – Microsoft Word, Excel, and Outlook
• Experience in Commercial and Personal lines
• At least 5-years’ relevant work experience in claims validations and settlement (both in Motor and NonMotor claims, as well as in both Personal Lines and Commercial Lines classes of business)
• Work experience within a licensed insurer, or Underwriting Manager.
• Experienced in making claims settlement determinations with mandate exceeding R250 000.00
• Sound technical knowledge and understanding of relevant short term insurance policy wording