The main purpose of the Claims Specialist’s role is to validate and process short-term insurance liability claims. The Claims Specialist will furthermore provide guidance and advice (legal) on the interpretation of policy wordings, coverage under the respective policies, undertake merit/liability assessments as well as quantification in respect of large and/ or complex claims, deal with litigation and assist with all complaints made to insurance regulatory bodies.

Required Qualifications

• Matric Certificate – essential
• Regulatory Exam
• A formal Degree in Law is preferred. Alternatively, a formal Degree in Risk Management or Short-Term Insurance
• Class of Business certification (Personal Lines & Commercial Lines) – Highly advantageous
• Must be compliant with FAIS Fit and Proper requirements with a track record of working unsupervised.

• At least 5-10 years of relevant work experience in claims validations and settlement (both in Motor and Non-Motor claims, as well as in both Personal Lines and Commercial Lines classes of business) or work experience in a law firm specializing in dispute resolution, litigation and insurance.
• At least 5 years of experience in dealing with all aspects of Liability claims
• Experience in dealing with litigious matters
• Must be experienced and mandated to make claims settlement determinations for large losses and/ or complex commercial claims (R 2 million or higher)
• Work experience within a licensed short-term insurer, or Underwriting Manager
• Sound technical knowledge, understanding, and practical application of relevant short term insurance product wording, including niche products such as Marine and Engineering.
• Experience in complaints resolution (Regulatory and OSTI related)
• Review and approval of rejections
• Participation in operational claims management meetings with managers, brokers, and portfolio managers.
• Provide key guidance, advice, and recommendation for improvement in policy wordings
• Provide governance advice in terms of the relevant legislative and regulatory regime\
• Ability to plan and prioritise own time and work commitments to deliver timeous claims service within agreed turnaround times
• Ability to think independently and to work without supervision.
• Ability to take initiative and respond pro-actively and independently to situations to secure positive results
• Accepts ownership and accountability for one’s own actions and decisions
• Is open to learning opportunities and is committed to continuous self-development
• Ability to communicate openly, and with impact
• Ability to adapt one’s communication style and content to the audience and context.
• Ability to easily connect with others and develop professional relationships and partnerships with others
• Strong listening skills
• Demonstrate high levels of customer centricity and empathy
• Effective numerical skills and ability to think analytically with good attention to detail
• Ability to identify risks and trends in relation to liability claims.
• Solution based thinking
• High levels of self-perception (confidence, self-empowerment, optimism, self-respect)
• Ability to function independently, demonstrating good control and composure under pressure
• Must have high inner values of Honesty, Integrity and reliability