Job Description
Duties and Responsibilities
Key Tasks & Accountability
Effective Processing of Claims
• Promptly handle marine claims and take responsibility to resolve all enquiries from both customer and external contacts to ensure delivery of a focussed claims service.
• To develop a claims case strategy to ensure that appropriate reserves are assigned, investigations conducted, and appropriate suppliers engaged.
• Acquires and efficiently organises the relevant evidence and information to accurately assess the value of the claim and to recognise potential fraud and recovery indicators.
• Reviews, resolves, and proactively finalises claims within authority limits ensuring settlement at an optimum level.
• Prepares reports and engages with reinsures and global claims on cases that are likely to exceed retention.
• Adheres to local regulatory and governance requirements throughout the life of the claim to ensure that we make decisions using the right standards.
• Refers to customer specific claims handling protocol and/or customer proposition service charter to ensure that we understand and fulfil the needs and expectations of our customers
Requirements
• Degree
• 5 years + specific claims experience
• Technical knowledge of products and services
• Expert technical claims handling knowledge across a broad range of lines of business/claim types
• Knowledge of legal systems and interpretation of legal liability
• Knowledge of industry standards and protocol
• Able to understand the claims market agreements that exist within the various territories and how to access the specific knowledge
• Have had previous experience in managing and handling difficult coverage issues and be able to give examples
• Awareness of the litigation process through all courts.
• Knowledge of how to identify and engage with lead experts.
• High level awareness of interdependencies with other Company Functions (Finance, Reinsurance, Marketing, Actuarial, Underwriting and Legal)
• High level awareness of market/industry issues
• Recognises relevance of customer proposition and how to interpret specific handling requirements
• Recognise the benefit of providing excellent customer service
• Be able to articulate how to prioritise and work to deadlines
• Desire to learn and be flexible to business change
Relationship
Internal
• To report to manager
• Engage and collaborate with other colleagues within the Claims Functions
• Engage and collaborate with other Functions such as Underwriting
• Engage, and inform internal customer stakeholders
External
• always Working lawfully and in accordance with pre- defined regulatory compliance and financial requirements.
• Working at all times in accordance with procedures, group/company policy, processes and controls e.g. the Internal Control Framework
• Ability to recognise and understand appropriate legislative regulations specific to each territory covered within the role.
To apply, use the link: www.********.co.za
ATripleA Recruitment and Temps
www.********.co.za
#atriplea #recruitment #vacancy # Claims# Specialist# Marine
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