Claims Specialist - Liability

Job Description

A leader in the UMA space seeks a liability claims specialist to join their organisation. 

 

The role will include the following: 

Claims Practice Management 

 

·         Attend and manage all aspects related to a portfolio of high quantum specialist Liability claims such as claims registration, case management, drafting, diary, recoveries, and settlement negotiations.

·         Draft settlement agreements and other legal documents within mandate.

·         Strategically manage a portfolio of claims.

·         Manage loss adjusters and attorneys appointment on matters and ensure compliance with agreed service level agreements.

·         Monitor and manage legal spend of attorneys and loss adjusters.

·         Manage system processing and compliance with systems by way of payments, updating signed off reserves, proper recordal of information etc, 

·         Attend to Operational duties as allocated 

·         Compile and manage risk reports when required

·         Actively manage and record claims above certain thresholds on Risk Module and report on matters to Claims Co and Executive where required.

·         Comply with internal and external regulatory framework and internal and external processes and procedures in accordance with organisational standards.

·         Draft processes and procedures that are compliant with relevant regulatory framework and applicable legislation. 

·         Effectively liaise and interact with Underwriters. 

 

Analysis

 

·         Consider, analyse and interpret insurance policy and the contractual impact thereof for the determination of coverage;

·         Critically analyse the facts of the matter and their impact on the underlying policy.

·         Draft opinions on the interpretation of coverage in relation to the facts and the applicable policy, present and motivate;

·         Draft opinions on merits and quantum of matter with the relevant caselaw and legislation applicable;

·         Apply critical thinking to ensure appropriate decisions on merits and policy response.

·         Critically consider and evaluate information provided and identify information required.

·         Conduct a strategic assessment of claims and make strategic decisions and recommendations on handling of claims.

·         Develop and maintain an understanding of technical and legal aspects impacting on the policy’s operation.

·         Make representations and recommendations on improved wording and trends identification to underwriters

 

Individual Claims Leadership

 

·         Provide appropriate and required level of involvement, assistance and/or guidance to junior Claims Staff;

·         Assist Management team in providing continuous training and development to claims department.

·         Assist in identifying and developing SOP’s and processes to ensure claims department effectiveness.

·         Take initiative in creating opportunities of interaction with Brokers and Insureds. 

 

 

 

Client Liaison (Internal and External)

 

·         Liaise with clients to resolve queries to the satisfaction of the affected parties within the scope of authority and / or responsibility.

·         Prepare for and attend meetings and consultation with brokers, insureds, legal representatives and loss adjusters

 

The requirements for the role are:

  • Previous Casualty insurance experience – minimum 3years.
  • Preference will be given to candidates with Liability experience.
  • Matric
  • Admitted attorney with LLB
  • FAIS compliance 
  • Ability to strategise and drive a claim to finality
  • High level of technical skill specifically relating to Casualty Insurance

 

 
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Contact

Dominique Bennett
+27 (0) 11 759 4039
 
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