Claims Officer

SUMMARY:
Resourceful, attentive, self-motivated, individual with a minimum of 3 years experience in reinsurance claims processing/management.

POSITION INFO:

JOB SUMMARY:

• To ensure efficiency and effectiveness in the management of claims as a key competitive tool and for promoting business performance, business sustainability and customer satisfaction.
• To ensure all and only valid claims deriving from the Companys business contracts in force are settled promptly and accurately. 
• To develop, mantain and update relevant and reliable statistics on the claims experience on the Companys business contracts.
• To promote the Companys image, reputation and commitment to honour its obligations. 

PRIMARY RESPONSIBILITIES:

Receive, record, review, validate and process claims and cash loss payment requests. Review and check claim documentation for completeness and accuracy of computation of both the FGU amounts and the Companys shares. Check to ensure adequacy of documentation support, claim justification, premium payment and policy attachment.

Validate the accuracy of claims notification and payment requests in terms of the computations, allocation of shares among participating entities, computation of reinstatement premium, tax amounts and outstanding claims figures.

Provide technical expertise and reasoned judgement in reviewing and accepting/declining claims notifications and claims payment requests, ensuring conformity to the Underwriting Manual, claims payment guidelines and procedure, policy attachment and sound business considerations. Maintain suitable documentation for ease of reference. 

Review and recommend Management authorisation for the settlement of all bona fide claim payments and cash call requests in comformity with all applicable claim payment guidelines and procedures.

Ensure the regular updating of the Claims Register with the required information on all claim notifications received.

Establish and maintain suitable documentation on all claim notifications received and treated for ease of reference.

Ensure the documentation and regular updating of the list of all unjustified claim presentations for ease of reference.

Advise Management of all large loss amounts as soon as receiving the related claims notifications from clients.

Undertake regular visits to/ hold regular meetings with all assigned clients (especially brokers and cedants) in order to gain proper understanding of their claims handling, claims documentation and claims management procedures, to test the reliability of their claims computations and apportionments, to obtain statistics and information on the clients especially in relation to claims incidents and history, to obtain information or resolve any issues regarding specific claims, and to generally maintain a close relationship with business partners for the mutual benefit of both parties.

Undertake specific claims review and audit visits to assigned clients with Management approval, involving but not limited to the review and audit of client claim documentation, procedures, and outstanding claim reserves, and making recommedations to Management thereon.

Develop and maintain up-to-date statistics on claims incidences/ loss events, claims paid, outstanding claims, and the overall level of claims incurred by the Company on its underwriting business.

Develop and maintain adequate reserves to meet the notified claims and other outstanding claims obligations of the Company.

Monitor and advise Management on any claim accumulations (actual or potential) arising from one loss event or series of related loss events.

Record, monitor and follow up on all salvage and other outstanding recoveries until realised or otherwise finalised.

Prepare regular (monthly, quarterly, annual and other periodic and/ or adhoc) reports and reviews on the incidence of claims suffered by the Company.

Promote productivity, good conduct, discipline, loyalty and team spirit with and amongst colleagues.

Provide effective client service through rendering efficient, yet professional service to all clients without compromising the policy, procedural and control requirements of the Company in the management of claims and the discharge of other assignments.

Provide required information, explanations and responces to technical inspection, regulatory oversight and other supervisory requests on matters relating to claims and ensure the implementation of all approved recommendations emanating therefrom under the direction of the Claims Manager.

Provide support, expert advise, training and other technical assistance to clients on a need/request basis (especially on claims documentation, handling and procedures) as may be directed and/ or approved by the Claims Manager in furtherance of the business interests of both the cedants and the Company.

QUALIFICATIONS, EXPERIENCE AND PERSONAL ATTRIBUTES:

Bachelors degree (BSc, Bcom) in Insurance, Risk Management, Economics, Business Administration or related field plus minimum of three years experience in reinsurance claims processing/ management. 

OR

Post-Matric qualification (including membership of a relevant professional association) plus a minimum of five years experience in reinsurance claims processing/ management.

Working knowledge of Microsoft Office products especially Office 365.

Basic knowledge of enterprise resource planning solutions such as Oracle E-Business Suite will be an added advantage.

Basic knowledge of insurance and reinsurance operations will be an added advantage.

Attention to detail.

Strong problem-solving, communication, observation, quantitative and analytical skills.

Self-motivated.

Willingness to learn.

Please note: This position is open to qualified black South Africans only and attracts market-competitive remuneration that is based on the appointed candidates qualifications and experience.

Application documents comprising application letter, comprehensive curriculum vitae (including physical, telephone and two referees’ contact details), copies of qualifications and a copy of national identity card document should be provided.

NB! This job is now closed. You can apply for other jobs by uploading your CV.