Portfolio Claims Specialist - Bedfordview, South Africa
2 days ago
Job description
We are seeking an experienced Portfolio Claims Specialist to join our dynamic insurance team. In this role, you will be responsible for processing, validating, negotiating, and settling a dedicated portfolio of broker-specific motor and non-motor claims across both Personal and Commercial Lines. You will collaborate closely with allocated brokers, providing support, guidance, and coaching to ensure claims are managed within agreed mandates and in compliance with company procedures.
The successful candidate will handle all claims that exceed broker mandates, assist with high-value and complex claims, and ensure accurate processing in accordance with all regulatory and operational guidelines.
Key Responsibilities
- Process, validate, and settle individual and broker-submitted motor and non-motor claims for Personal and Commercial policies
- Negotiate and facilitate payments of claims, including those above the broker's authority/mandate
- Provide coaching, training, and support to binder and outsource brokers to strengthen claims validation and settlement processes
- Review, action, and authorize claims exceeding brokers' mandates in line with company procedures
- Assist with complex and high-value claim assessments for both Motor and Non-Motor portfolios
- Manage and process all liability claims in compliance with the Liability SOP and guidelines
- Collaborate with the Portfolio Claims Manager on litigation matters and contribute expertise to dispute and litigation resolution
- Maintain accurate records and ensure claims handling is fully compliant with company and regulatory standards
Minimum Requirements
- Matric Certificate (compulsory)
- RE5 Certification (Regulatory Examination)
- Higher Certificate in Short Term Insurance NQF 5 or Full Qualification NQF 4
- Class of Business Certification: Personal Lines & Commercial Lines
- FAIS Fit and Proper compliant with a proven track record of working independently
- Minimum 5 years' experience in claims validation and settlements within Motor & Non-Motor (Personal & Commercial Lines)
- Demonstrated experience in liability and litigation matters
- Experience working within a licensed insurer
- Experience settling claims with mandates exceeding R50,000
- Proficient in Microsoft Office Suite (Word, Excel, Outlook)
- Excellent negotiation, communication, and interpersonal skills
Desired Skills & Competencies
- Strong analytical and problem-solving skills
- Ability to manage multiple priorities and portfolios simultaneously
- Solution-oriented with excellent attention to detail
- Confident decision-maker
- Effective relationship builder with brokers and internal teams
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