Complex Claims Controller

Recruiter:

PreBless Group

Job Ref:

SARPG

Date posted:

Sunday, September 5, 2021

Location:

Johannesburg, South Africa

Salary:

negotiable

SUMMARY:
To ensure compliance with the short term insurance regulations as well as to assist the Claims Manager with the management of complex claims.

POSITION INFO:

Complex Claims Controller

ROLE DESCRIPTION

Job summary statement/purpose

The Complex Claims Controller will ensure effective processing of claims within the governed framework, to ensure compliance with the short term insurance regulations as well as to assist the Claims Manager with the management of complex claims.

KEY PERFORMANCE AREAS (DUTIES & RESPONSIBILITIES):

Claims processes

Undertake claims processing by receiving registered claims that are within mandate, check & maintain correct reserves and keep a regular follow-up on outstanding documents.
Approve and settle claims within delegated authority after verification of all documents and validation thereof under the policy cover.
Assist in the extrapolation of monthly reports on claims.

Agency/ broker Liaison

Inform reinsurers, brokers, underwriting & legal departments and loss adjusters accurately and promptly of large losses.
Exercise proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim.
Ensure identification of all claims where appointment of surveyors, adjusters or legal representation or litigation is involved and advise the Claims Manager and relevant Executives.
Interpret related claims documentation and negotiate settlement and disposition of complex claims.

Strategic assistance

Provide input in the compilation of the departmental annual plan.
Provide input on the review of the claims processes.
Review and enhance the claims procedure manual for evaluation by the Claims Manager.
Continuously review departmental risks.
Establish gaps between industry developments and Organisation covers.
Compile Statistical Reports.
Manage service level agreements with suppliers and ensure deliverables are satisfactory.

Perform ad hoc tasks

Perform any reasonable tasks as and when required by the Line Manager Qualifications:
Degree / Diploma preferable
Higher Certificate in Insurance preferable Experience:
7 – 10 years’ experience in a Claims position of short-term Insurance company. Knowledge:
Sound knowledge of claims procedures
Understanding of claims analysis and settlement
Understanding relevant legislation
Understanding of Short Term, commercial and property insurance Technical Skills:

CLOSING DATE: 06 September 2021

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

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