Senior Claims Assessor - Commercial Insurance

Our client, a prominent player in the South African insurance sector, is seeking a highly experienced and analytical Senior Claims Assessor to join their dynamic team in
** Pietermaritzburg, Kwa Zulu-Natal**. This is an exciting opportunity for a seasoned professional to contribute to the effective management of complex commercial insurance claims. The role involves thorough investigation, assessment, and resolution of claims, ensuring adherence to policy terms and conditions while maintaining a high level of customer satisfaction. You will play a crucial role in risk mitigation and financial accuracy within the claims department, working within a supportive and growth-oriented environment.

This position offers a hybrid work arrangement, blending the benefits of in-office collaboration with the flexibility of remote work, allowing for a sustainable work-life balance in the vibrant region of
** Pietermaritzburg**.

• Investigate, evaluate, and process complex commercial insurance claims in accordance with policy coverage and company guidelines.
• Conduct thorough assessments of damages, liabilities, and quantum of claims, requiring detailed analysis of supporting documentation.
• Liaise effectively with policyholders, brokers, legal representatives, and other relevant parties to gather information and facilitate claim resolution.
• Negotiate settlements with claimants and/or their representatives in a fair and timely manner.
• Identify potential fraudulent claims and elevate them to the appropriate internal departments for further investigation.
• Maintain accurate and comprehensive claim files, ensuring all activities and decisions are meticulously documented.
• Provide expert advice and guidance to junior claims staff and other stakeholders on claims-related matters.
• Contribute to the continuous improvement of claims handling processes and procedures.
• Ensure compliance with all relevant regulatory requirements and industry best practices.
• Contribute to the achievement of departmental Key Performance Indicators (KPIs).

• A minimum of 5 years of proven experience in claims assessing, with a strong focus on commercial insurance lines.
• Comprehensive understanding of insurance principles, policy wordings, and relevant legislation within
  ** South Africa**.
• Excellent analytical, problem-solving, and decision-making skills.
• Strong negotiation and communication abilities, both written and verbal.
• Proficiency in claims management software and Microsoft Office Suite.
• A relevant tertiary qualification in Insurance, Law, Commerce, or a related field is highly advantageous.
• Ability to work independently and as part of a team in a hybrid work environment.
• Demonstrated ability to manage a demanding workload and meet strict deadlines.
• High level of integrity and attention to detail.
• Residency or willingness to commute to
  ** Pietermaritzburg, Kwa Zulu-Natal
  ** for the in-office component of the hybrid role.

• Competitive salary package commensurate with experience and qualifications.
• Performance-based bonuses and incentives.
• Comprehensive medical aid and retirement fund contributions.
• Generous leave allowance and potential for study leave.
• Opportunities for professional development and career advancement within a leading insurer.
• Supportive and collaborative work environment.
• Hybrid work model offering flexibility and work-life balance.
• Exposure to a wide range of complex and challenging commercial claims.