Short-Term Claims Junior Assessor (RE5) - Pretoria East

SUMMARY:

Role Purpose

Key Responsibilities

Claims Assessment & Processing

• Assess allocated short-term insurance claims against policy terms, conditions and limits.
• Gather and verify all required documentation from policyholders, contractors and service providers.
• Evaluate claims for indemnity, ensuring accurate application of policy conditions, exclusions and excesses.
• Process straightforward claims within delegated authority levels.
• Escalate complex, disputed or high-value claims to senior assessors with comprehensive supporting information.
• Maintain accurate claim records and supporting documentation.

Claims Investigation & Assessment Support

• Conduct desktop assessments using photographs, quotations and supporting reports.
• Assist with on-site inspections where required under the guidance of senior assessors.
• Review contractor quotations and identify discrepancies requiring further investigation.
• Develop knowledge across common homeowners' insurance claim categories.
• Support accurate claim validation and settlement recommendations.

Fraud Detection & Risk Management

• Identify potential fraud indicators during claim assessments.
• Verify supporting documentation and assess claim consistency.
• Escalate suspicious or irregular claims in accordance with company procedures.
• Support fraud prevention initiatives through diligent claim assessment.
• Maintain a high level of professional scepticism during investigations.

Regulatory Compliance

• Ensure claims are assessed in accordance with applicable insurance legislation and regulatory requirements.
• Apply fair claims handling principles throughout the assessment process.
• Maintain complete and auditable claim records.
• Ensure written communications meet regulatory standards.
• Adhere to internal policies, procedures and service standards.

Customer Service & Stakeholder Engagement

• Communicate professionally with policyholders, brokers, contractors and service providers.
• Provide regular updates on claim progress.
• Manage customer expectations through clear and accurate communication.
• Collaborate with internal claims teams to ensure seamless claim resolution.
• Escalate customer complaints appropriately.

Learning & Development

• Participate in ongoing training and mentoring programmes.
• Develop technical knowledge of insurance products and policy wordings.
• Attend quality assurance, calibration and team meetings.
• Remain informed of legislative and policy updates affecting claims.
• Continuously develop assessment and investigation skills.

POSITION INFO:
Role Requirements Minimum Qualifications Grade 12 (Matric). RE5 qualification completed or in progress will be advantageous. National Diploma or Bachelor's Degree in Insurance, Business Administration, Built Environment or a related field will be advantageous. Relevant short-term insurance qualification will be advantageous. Experience Minimum 1-2 years' experience within a short-term insurance claims environment. Experience in claims administration, claims consulting or junior claims assessment. Exposure to homeowners' insurance claims will be advantageous. Experience interpreting insurance policy schedules and supporting documentation. Exposure to claims management systems will be beneficial. Required Skills & Competencies Technical Skills Knowledge of short-term insurance claims processes. Understanding of policy interpretation and policy conditions. Ability to assess quotations and repair estimates. Claims investigation techniques. Basic fraud awareness. Strong numerical ability. Computer literacy, including Microsoft Office. Claims administration and record management. Behavioural Competencies High attention to detail. Analytical thinking. Sound judgement. Strong problem-solving ability. Customer-focused approach. Excellent communication skills. Professional integrity. Empathy and emotional resilience. Ability to work under pressure. Team player with a willingness to learn. Strong organisational and time management skills. Key Performance Areas Candidates will be evaluated on their ability to: Assess claims accurately and efficiently. Maintain high levels of regulatory and procedural compliance. Deliver excellent customer service throughout the claims process. Identify and escalate potential fraud risks appropriately. Maintain accurate claims documentation and records. Meet turnaround times and productivity targets. Demonstrate continuous learning and technical development. Work collaboratively within the claims team. Maintain quality and accuracy in claim assessments. Contribute to continuous improvement within the claims function. Should you not receive a response within 10 working days, please consider your application unsuccessful.