Senior Claims Officer at Sanlam Investments East Africa (SIEA)

Purpose:

• The role will be responsible for the entire claims' lifecycle, from initial contact with the policyholder to final claim settlement while ensuring adherence to company policies, regulatory requirements In addition, the role will deliver exceptional customer service and ensure efficient claims handling

Primary responsibilities:

• Claims Handling
• Claim Registration: Collecting initial details from policyholders regarding the incident and registering the claim in the system
• Documentation: Gathering necessary documents such as police reports, repair
• estimates, and photographs of the damage
• Conducting investigations to verify the authenticity of the claim
• Processing payments for repairs or total loss settlements and ensuring timely resolution of claims
• Coordinating with external experts such as loss adjusters, medical professionals, or legal advisors as needed
• Engaging in discussions with claimants, legal representatives, and other stakeholders to reach a fair settlement
• Independently manage a portfolio of assigned claims, ensuring timely and efficient resolution
• Ensure accurate claim reserving, reflecting the estimated cost of settlement throughout the claim lifecycle

Reinsurance Claims

• Timely reinsurance claims recoveries and documentation
• Maintaining minimal reconciliation differences through prompt processing of identified reconciliation differences
• Notifying reinsurers of cash call claim and following up for timely payments Ensuring that claim allocations are properly captured in the systems General correspondence with reinsurers

Customer Service:

• Provide exceptional customer service to policyholders throughout the claims process, keeping them informed of the progress and addressing their concerns promptly
• Clearly explain claim procedures, coverage details, and settlement decisions to policyholders
• Build positive relationships with policyholders and strive to exceed their expectations Efficiency and Accuracy:
• Manage caseload efficiently, meeting deadlines and adhering to established procedures
• Maintain accurate and complete claim files, ensuring proper documentation of all communication and decisions
• Identify and implement opportunities for process improvement to streamline claims handling

Teamwork and Collaboration:

• Work collaboratively with other departments to ensure a smooth claims resolution process
• Provide guidance and support to claims officers, fostering a team environment focused on continuous learning

Reporting

• Preparing detailed reports on claims activities and outcomes for internal review and external reporting

Person Specifications Academic Qualifications

• Bachelor's degree in business / Insurance or its equivalent from a recognized institution

Professional Qualifications

• Diploma in Insurance from AllK/ACII or its equivalent from a recognized institution; and
• Member of AllK /ACII or a relevant professional body

Experience

• Minimum of six (6) years' relevant experience

Skills and Attributes

• Knowledge of regulations by AKI and IRA
• Inter-personal skills (eg presentation and communication skills, organizational skills, teamwork, etc)
• Intra-personal skills (eg, self-discipline, enthusiasm, self-motivation, etc) Good problem solving and analytical thinking skills
• Strong people-management and team player skills
• Results driven, and customer focused