Short Term Buildings/Structural Claims Junior Assessor - Pretoria East

SUMMARY:

Role Purpose

Key Responsibilities

Claims Assessment & Processing

• Assess allocated homeowners' insurance claims in accordance with policy terms, conditions, exclusions, and limits.
• Gather and verify all supporting documentation from policyholders, contractors, service providers, and internal stakeholders.
• Assess claims for indemnity, ensuring accurate application of excesses, policy conditions, and settlement calculations.
• Escalate complex, disputed, or high-value claims to senior assessors with clear supporting documentation.
• Process approved claims within delegated authority while maintaining compliance with internal controls.

Buildings & Structural Claims Support

• Conduct desktop assessments using photographs, contractor reports, repair quotations, and supporting documentation.
• Assist with site inspections under the guidance of senior assessors where required.
• Evaluate repair quotations and scope-of-work documents, identifying discrepancies or areas requiring further investigation.
• Assess common homeowners' claims including:
  • Storm damage
  • Fire damage
  • Burst pipes
  • Geyser failures
  • Power surge claims
  • Subsidence and structural damage
• Apply building and structural knowledge when evaluating claims and determining appropriate outcomes.

Fraud Identification & Risk Management

• Identify potential fraud indicators during the assessment process.
• Escalate suspicious claims promptly in accordance with company procedures.
• Verify supporting documentation and investigate inconsistencies where necessary.
• Promote fraud awareness through accurate claim validation and reporting.

Regulatory Compliance

• Ensure all claims comply with applicable Short-Term Policyholder Protection Rules (PPRs).
• Apply Treating Customers Fairly (TCF) principles throughout the claims process.
• Maintain complete, accurate, and auditable claim records.
• Ensure assessment decisions comply with company policies and regulatory requirements.

Customer & Stakeholder Engagement

• Provide professional and empathetic service to policyholders throughout the claims process.
• Keep customers informed of claim progress and manage expectations effectively.
• Liaise with brokers, contractors, suppliers, and internal Claims Consultants to facilitate claim resolution.
• Escalate complaints or customer concerns in line with internal procedures.

Continuous Learning & Development

• Participate in coaching, mentorship, and formal training programmes.
• Keep up to date with policy wording changes, regulatory developments, and claims best practices.
• Participate in quality reviews, calibration sessions, and team meetings.
• Contribute to continuous improvement initiatives within the claims department.

POSITION INFO:

Role Requirements

Qualifications

• Grade 12 (Matric) (Essential).
• RE5 qualification completed or in progress (Advantageous).
• National Diploma or Bachelor's Degree in Insurance, Business Administration, Built Environment, or a related field (Advantageous).
• Short-Term Insurance qualification through the Insurance Institute of South Africa (IISA) or equivalent (Advantageous).

Experience

• Minimum 1–2 years' experience within a short-term insurance claims environment.
• Proven experience in buildings, structural, or non-motor homeowners' claims is essential.
• Experience assessing homeowners' insurance claims, including policy interpretation and claim validation.
• Exposure to claims administration or claims management systems.
• Experience reviewing contractor quotations, repair estimates, and policy documentation will be advantageous.

Knowledge & Skills

• Good understanding of homeowners' insurance policies, cover, exclusions, and policy conditions.
• Working knowledge of residential building construction, including roofing, plumbing, walls, foundations, and structural components.
• Ability to interpret contractor quotations, repair scopes, and supporting documentation.
• Understanding of Short-Term Policyholder Protection Rules (PPRs), Treating Customers Fairly (TCF), and basic fraud indicators.
• Good numerical ability with accurate settlement calculations.
• Computer literacy with proficiency in Microsoft Word, Excel, Outlook, and claims management systems.
• Excellent communication, organisational, and customer service skills.
• Strong analytical ability with excellent attention to detail.
• Ability to work under pressure while managing multiple claims effectively.