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.
· 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: