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Complex Claims Specialist – Parktown needed at Hollard Insurance

Job title : Complex Claims Specialist – Parktown

Job Location : Gauteng, Johannesburg

Deadline : April 05, 2024

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Role Objectives:

  • Process all complex claims assigned, with a focus on all claims above Branch Mandate, within the set 
  • standards required by the company thus contributing to the effectiveness and efficiency standards
  • of the Team, and the Company at Large. 
  • Managing complex claims according to the CCU Project Methodology, mitigating risk, and managing 
  • budget, engaging with key stakeholders, and tracking timeline against Claims Framework
  • Enhance the image of the company through the continuous delivery of efficient and effective 
  • customer service.
  • Ensure all technical aspects & specialist functions for claims management and fulfilment are 
  • adhered to.

Key Responsibilities:

  • Technical expertise: To effectively validate Large Losses against Policy provisions, and general policy 
  • conditions and requirements with a view on fair settlement, and simultaneously ensure prevention
  • and mitigation of leakage to the company. . Manage claims end- to-end.
  • Use knowledge and Skill to evaluate and validate all Complex Claims.
  • Stakeholder Management: Maintain a high level of service to all stakeholders identified (internal and 
  • external) according to their respective SLA’s.
  • Reporting: Provide necessary reporting on financial and operational indicators relating to claims, 
  • keep all records and registers up to date. Provide feedback (reporting) to senior management on
  • achievements, pending issues, concerns, and suggested recommendations.
  • Effective and timeous communication: Communicate in a professional manner with internal and 
  • external parties and respond to queries within 24 hours. Keep concerned parties abreast of claims 
  • status and development, utilising the Project Management Methodology as represented in the Pack 
  • making up a POE (Portfolio of Evidence)
  • Estimate Management: to ensure that estimates loaded are accurate, justified by means the 
  • necessary supporting documentation, monitored and managed.
  • Must have a good understanding of Treaty vs Fac Reinsurance. 
  • Risk management: Can spot an adverse risk, to enable suggestions for future risk mitigation. 
  • Facilitating monthly triangulate meetings between claims, risk, and underwriting
  • Recordkeeping & Reporting: As and when requested.
  • Quality control: Quality standards to be adhered to always
  • Relationship management: Working with and support the claims teams in the regional offices as well 
  • as managing relationships with loss adjustors and specialists. 
  • Continuous Process Improvement: Ensure full compliance to all processes, policies and procedures  and identify areas for improvement.
  • Variance Management: Adhere to standards set by Hollard. Provide action plans and follow up with corrective actions to all variances.
  • Employee Growth: Take responsibility for your own career growth and have regular discussions with  the relevant stakeholders.

Required Knowledge and Experience    

  • Good knowledge of specialist risk insurance, with a focus on Commercial Claims
  • At least 10 years Claims Experience, of which 5 years should be Commercial Claims. 
  • Minimum NQF Level 6
  • Good knowledge of specialist risk insurance with at least 5 years Commercial Claims experience 

Educational Requirements    

  • Tertiary Qualification from a recognised Institution 
  • Re 5 (Fais Exam) will serve as an advantage

How to Apply for this Offer

Interested and Qualified candidates should Click here to Apply Now

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