Santam Marine has a profession probability for a Senior Claims Specialist in the Claims branch which will be primarily based in Gauteng.
The profitable candidate will control a complicated portfolio of claims from notification to closure, investing the vital degree of involvement required for every declare relying on, inter alia, the nature, category, maturity, kind and quantum of the claim. This consists of however are now not confined to:
KEY RESPONSIBILITIES
Claims Portfolio Management
Regularly evaluate person claims inside the portfolio and hold reserves and information up to date as required through Santam Marine claims controls and standards.
Identify problems and traits in the portfolio and take excellent and/or corrective action.
Ensure that all claims rejections are referred to Management for dialogue earlier than submission to Client.
Demonstrating thorough and sound software of coverage understanding to claims.
Display honest felony appreciation in dealing with technical complicated claims.
Provide comments to management for all inside and exterior (OSTI) complaints withing the agreed provider stage agreement.
Escalate trouble claims to administration (summons/brand and or reputational damage/complaints and close to omit losses)
Follow at all instances Santam Marine Claims Reserving Philosophy and Claims Standards.
Provide enter to boost and execute claims techniques thinking about uncertainties, key decisions, chance management, and estimated related costs.
Understand and enforce Santam Marine’s “Treating Customers Fairly” policy.
Understand and execute the necessities set out by way of the Internal Osti and Client Liaison division for complaints inside the ethos of Santam Groups Claims Framework.
Working with Underwriters
Develop an perception of advertising and marketing and underwriting techniques for your enterprise vicinity and make contributions to enterprise improvement and renewal possibilities by means of attending purchaser conferences to provide an explanation for the Santam Marine claims philosophy and method to claims coping with and discussing any claims issues.
Provide enter to underwriters on overview of doable or current insured’s claims experience.
Provide remarks on claims developments and traits and their plausible affect on the book.
Collaborate with the marketing, underwriting and management concerning gray areas on coverage wordings.
Authority and Minimum Standards Observance
Operate inside your authorised claims authority at all times.
Implement minimal working and claim standards.
Have thorough information of enterprise policies and minimal requirements to make certain compliance with the guidelines and Santam Marine claims and underwriting manage requirements and protocols.
Third celebration Management
Follow Santam Marine claims processes for the choice and retention of third-party gurus and manipulate these relationships to the gain of Santam Marine claims.
Where required behavior declare file evaluations or audits and unravel any troubles identified.
KEY RESPONSIBILITIES
Broker and Insured Relations
Work proactively to strengthen and control sturdy family members with key brokers and insureds.
Promote the Santam Marine manufacturer of excellence and professionalism in purchaser service.
Updates and follow-ups with Brokers and Surveyors.
When required, furnish Broker with Loss Ratio Reports.
Where required attend conferences with Relationship Managers, make certain that the Claims Manager is included.
Claim Specialist and Claim Handler’s ought to no longer attend to conferences barring a crew chief and/or management.
Conflict of Interest
Adhere to Santam Marine Conflicts of Interest policy, alert the gorgeous man or woman to any plausible conflicts of activity and take steps to get to the bottom of them promptly.
Immediately advocate Head of Department if any Santam Marine Claims worker seeks to exert undue have an effect on on you or any different group member to act improperly in the management, reserving or agreement of any claim.
People Management
Day-to-day help and collaboration with the rest of crew in admire of review, signal off, mentoring and on the job education as and when required.
Contribute to, motivate and make certain teamwork in order to promote a healthful and engaged workforce.
Review changes of Claim Handler/s.
Client Liaison (Internal and External)
Respond to queries and get to the bottom of to the pleasure of the affected events inside the scope of authority and / or responsibility.
Prepare for and attend meetings.
Report to Team Leader and Management complicated claims and troubles bearing on to the complex/large losses.
General Administration
Produce reviews when required (Claims Summary).
Attend to the typing of regularly occurring correspondence when necessary.
Attend to each day administrative hobbies duties in accordance with organisational standards, strategies and procedures.
Appointment of healing marketers for 0.33 celebration recoveries.
Reviewing/Assessment of survey reports
Claim Adjustments
Appointment of Attorneys
Kit estimate, be aware updates and Kit diary follow-up’s
Review and test adjustment
Check and sign-off declare payment
Check and sign-off FX payments
Verify Bridger checks
Maintain a submitting gadget – All files should be uploaded onto MFiles
QUALIFICATIONS AND EXPERIENCE
Matric
Fais Compliance a preference
Relevant Legal or Commercial diploma a preference
Minimum 7 years true marine expert legal responsibility claims ride inclusive of an appreciation of reinsurance facultative inwards and outwards and complicated matters
COMPETENCIES
Good written and verbal conversation skills.
Computer literate
Written and Verbal verbal exchange capabilities (English)
Excellent negotiation abilities
Development of crucial competencies and capabilities
Excellent accounting and reconciliation competencies for declare adjustments
ADDITIONAL COMPETENCIES AND SKILLS
Strong Attention to Detail
Demonstrates Initiative
Strategic questioning and planning that challenges assumptions
A conceptual, lateral and analytical wondering balance
Excellent conversation abilities and potential to lead meetings
Strong relationship and typical administration skills
Financial competencies (budget management)
Delivery/ consequences orientation
Process administration and improvement
Conflict resolution
Strong negotiation and influencing skills
Strong Team focussed approach
Strong Focus on Risk and TCF
ABOUT SAMTAM
Santam is the market chief in the regular insurance plan enterprise in Southern Africa. As a large, diversified, and increasing company, we are dedicated to transformation and growth. While our headquarters are in South Africa, we are swiftly extending our presence into rising markets throughout Africa and Asia.
With a customer base of over 1 million policyholders, Santam serves individuals, business enterprises, professional commercial enterprise owners, and institutions—including eighty of the Top a hundred corporations listed on the JSE. Our dedication to Insurance, Good and Proper goes past simply offering cover—we provide peace of mind, making sure our customers can center of attention on residing in the moment, now not annoying about the unexpected. Because at Santam, we trust the freedom to trap each day is well worth protecting.
People power our business, and we are dedicated to attracting the great talent, whether or not for everlasting roles or non permanent opportunities.
Santam is dedicated to diversity, inclusion, and belonging. As an equal possibility employer, we motivate functions from candidates of all backgrounds, together with humans with disabilities. We are committed to neuro-inclusivity and fostering a administrative center the place all of us can thrive.
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