The Company is seeking to hire a Claims Officer, who will be responsible for managing and implementing claims programs for all lines of general business products.
S/he will manage a claim from the beginning, i.e. the time it is reported through to final settlementof the matter and beyond that if there is a recovery, to manage that recovery. Also, s/he may be involved in investigating potentially fraudulent claims and undertaking a range of Claims adjusting activities.
The ideal candidate for this role should be highly analytical and possess an in-depth knowledge of policies and regulations in the insurance industry. S/he must be able to work in a fast-paced environment.

Key Duties

Analyze and investigate complicated insurance claims to help prevent fraud.
Providing advice on making a claim and the processes involved.
Processing new General Business claims notifications.
Collecting accurate information and documents to proceed with a claim.
Where possible/appropriate, obtain or check the validity of the information provided by the claimant, consultants and other sources.
Interpretation of the policy wording and policy schedule to determine the extent of coverage and the application of any warranties, conditions or exclusions.
The identification and collection of any policy excess/deductibles.
Analyzing the claim made by a policyholder or third party and guiding policyholders on how to proceed with the claim.
Show respect, compassion and integrity to achieve a reasonable settlement and protect the brand.
Engaging people from a network of approved professionals ranging from repairers to lawyers, loss adjusters and medical advisersand arranging for them to make repairs or provide reports on the extent of the damage, loss or injury.
Reading to comprehend, loss adjusters, lawyers and expert opinion reports and ensuring they are complete and logical.
Monitoring the progress of a claim; investigating potentially fraudulent claims and identifying reasons why full payment may not be made.
Minimize claims leakage; that is the overpayment of claims or consultant fees or the payment of a non-valid claim.
Ensuring fair and prompt settlement of a valid claim by the insured.
Negotiating a prompt and commercially sound settlement with third-party claimants.
Building relationships with loss adjusters, forensic accountants and solicitors, as well as other legal/claims and consulting professionals.
Ensuring the customer is treated fairly and that the customer receives excellent service according to theindustry and company guidelines;
Involvement in loss adjusting and legal discussions relating to settlement;
Seeking legal recovery of monies paid out.
Taking responsibility for productivity and profit.
Providing claim reports that will enable strategic decision-making and business improvement
Adhering to legal requirements, industry regulations and customer quality standards set by the Management.

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