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The incumbent is responsible for providing technical claims support to the Claims Units in consultation with the Claims Manager-Technical Unit, to ensure that issues of quantum and liability are expeditiously addressed.
KEY POSITION RESPONSIBILITY:
Review and provide settlement recommendations, technical advice on claims referred by internal and external customers.
Conduct Audit of Claim files where required in compliance with regulators and the Company’s Claims Manual.
Monitor the effectiveness of Service Providers and make recommendations for improvements.
Collate information for claims activity analysis reports where required
Collate information for Statistical Reports for Internal and External Customers
Liaise with the Legal Division where required
Identify claims that require notification to Re-insurers and bring to the attention of the Technical Operations Division.
Participate in meetings and provide ideas and strategies to assist with the development of the Unit.
May be required to perform additional division related duties from time to time as instructed by the Manager.
Support a service focused environment and provide recommendations for improvements.
Effectively resolve Customer concerns as necessary.
Actively obtain Customer feedback and promptly correct deficient areas so identified.
Act as a subject matter expert for relevant learning and development programmes.
Create and conduct learning and development programmes and evaluations for assigned team members.
Complete any job-related function relevant to the Insurance Operations Property and Casualty Division that may be required.
KEY TECHNICAL COMPENTENCIES:
Advanced knowledge and understanding of the core principles of insurance and how this is applied.
Knowledge and understanding of the range of insurance products and services available in the market.
Knowledge and understanding of regulatory requirements and how to meet these on a day-to-day basis.
Advanced knowledge of how claims should be handled and managed.
Advanced knowledge and understanding of the claim’s notification process, how claims are validated and investigated.
Advanced knowledge and understanding needed to agree quantum and settle claims, identifying any opportunities for recoveries.
Advanced handling of individual and portfolios of claims cost effectively, minimizing claims leakage, and meeting organizational and customer claims service standards.
Knowledge of the underwriting process.
QUALIFICATIONS AND EXPERIENCE:
Bachelor degree in Insurance and Risk Management OR BA Degree in Management, Business Administration or other related field or technical certification.
CII Diploma or MICIA or PLAP or IIA Associate or AIC (Grade 1-2)
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Senior Claims Technical Officer
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