Summary:

CLAIMS NEGOTIATOR required for a well-established insurance company based in the East Rand to contribute to the organisational goals by processing and validating insured (and third party) claims with reasonable timeframes to meet the needs and requirements of the insured. Must be results orientated and able to thrive within a high pressure, dynamic environment. A strategic thinker who follows a decisive and proactive approach. A team player that is committed to acting with integrity, responsibility, and accountability.

Minimum Requirements:

• Admitted attorney
• LLB
• At least 2 years experience in contracts law and litigation (prepares the candidate because of the necessity to research and determine merits)
• Prepared to study towards a full FAIS/insurance qualification
• Must do Regulatory Representatives exam
• Engineering industry / Contractual claims and Engineering insurance industry knowledge is an advantage
• Experience in Professional Indemnity and Liability claims would be an advantage (not motor third party recoveries)
• Bilingual
• Efficient in Word, Excel and Outlook
• Good communicator (verbal and written)
• Must be a problem solver (able to assimilate large amounts of information and apply policy wording)
• Basic knowledge of Insurance Law

Duties and Responsibilities:

Operational

• Sound knowledge of claims principles in industry including Claims management (will be trained)
• Actively manage and oversee start to end of claims.
• Contribute to the growth and profitability of the Company by providing excellent service and maintaining relationships
• Manage and organise day to day operations by establishing priorities to ensure registering, handling and settling of claims on Company’s delegated authority and at the same time maintain the standards of the claims department
• Controlling of registers, compliance with SLA’s, diary management, quantum, recoveries, salvage and secure proper claims maintenance.
• Assess the claims internally.
• Ensure all technical aspects for claims settlement are adhered to.
• Negotiate settlement of the claims with all relevant stakeholders.
• Daily diary files to be extracted and dealt with e.g. letters of demand, final notices reminders and follow up assessors’ reports.
• Processing payments on system.
• Registering claims with the reinsurers/co insurers
• Facultative reinsurance and co-insurance recoveries
• Monitor and periodically review estimates
• Appointment of investigators, assessors, loss adjusters and other experts if necessary
• Negotiate best settlements.
• Attend to Third party claims in terms of the Plant and Contractors Third Party Liability cover
• Signing off of third party releases.
• Third Party recoveries.

Relationship Management

• Liaising in a professional manner with brokers and other insurers in respect of claims aspects
• Following up on regular intervals and provide constructive feedback to brokers and management.
• Respond to queries within 24 hours.
• Liaising with attorneys, giving instruction to attorneys to act on Insurers behalf
• Work with different people internally and externally to improve service, efficiency, and improve presentation of information
• Procure service providers and partners, negotiate costs
• Actively build, improve and maintain relationships with all stakeholders, i.e. internally and externally. Meet with brokers, service providers, partners and other divisions to ensure challenges they may face are addressed

Skills Required:

The Claims Negotiator must take ownership of claims allocated to him/her and must drive the matter to finality without undue delays, whilst considering all the information.

• Legal/construction expertise
• Understanding policy wording/documents (and consulting on intention where necessary)
• Drafting legally correct correspondence and documents
• Quality control of claims documents
• Reporting on claims
• Negotiating claims on merit and quantum
• Risk Management
• Liaising with specialists/Underwriters and using information gained to finalise claims
• Problem solving
• Decision making for discussion with management
• Customer service
• Innovation
• Understand applicable legislation
• Attentive to detail
• Need to be able to do extensive research
• Ability to analyse a set of circumstances and assemble a comprehensive timeline

Package on Offer:

• Basic salary negotiable (based upon experience and qualifications)

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