Liability and Litigation Claims Specialist

2 months ago222 views
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General Details
Advertised By:Agency
Company Name:CFS Recruitment
Job Type:Full-Time

The main purpose of the Claims Specialist’s role is to validate and process short-term insurance liability claims. The Claims Specialist will furthermore provide guidance and advice (legal) on the interpretation of policy wordings, coverage under the respective policies, undertake merit/liability assessments as well as quantification in respect of large and/ or complex claims, deal with litigation and assist with all complaints made to insurance regulatory bodies. 

Required Qualifications

  • Matric Certificate – essential
  • Regulatory Exam
  • A formal Degree in Law is preferred. Alternatively, a formal Degree in Risk Management or Short-Term Insurance
  • Class of Business certification (Personal Lines & Commercial Lines) – Highly advantageous
  • Must be compliant with FAIS Fit and Proper requirements with a track record of working unsupervised.
  • At least 5-10 years of relevant work experience in claims validations and settlement (both in Motor and Non-Motor claims, as well as in both Personal Lines and Commercial Lines classes of business) or work experience in a law firm specializing in dispute resolution, litigation and insurance.
  • At least 5 years of experience in dealing with all aspects of Liability claims
  • Experience in dealing with litigious matters
  • Must be experienced and mandated to make claims settlement determinations for large losses and/ or complex commercial claims (R 2 million or higher)
  • Work experience within a licensed short-term insurer, or Underwriting Manager
  • Sound technical knowledge, understanding, and practical application of relevant short term insurance product wording, including niche products such as Marine and Engineering.
  • Experience in complaints resolution (Regulatory and OSTI related)
  • Review and approval of rejections
  • Participation in operational claims management meetings with managers, brokers, and portfolio managers.
  • Provide key guidance, advice, and recommendation for improvement in policy wordings
  • Provide governance advice in terms of the relevant legislative and regulatory regime\
  • Ability to plan and prioritise own time and work commitments to deliver timeous claims service within agreed turnaround times
  • Ability to think independently and to work without supervision.
  • Ability to take initiative and respond pro-actively and independently to situations to secure positive results
  • Accepts ownership and accountability for one’s own actions and decisions
  • Is open to learning opportunities and is committed to continuous self-development
  • Ability to communicate openly, and with impact
  • Ability to adapt one’s communication style and content to the audience and context.
  • Ability to easily connect with others and develop professional relationships and partnerships with others
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