ntroduction
The Claims Administrator is responsible for processing and managing insurance claims within delegated authority. This includes ensuring claim validity, assessing liability, and negotiating settlements while maintaining excellent customer service and cost efficiency. All claims must be handled in accordance with the company’s governance framework and in compliance with short-term insurance regulations.
Duties & Responsibilities
1. Administration & Claims Processing
- Register new claims and process payments, including authorization.
- Examine and validate claims and all supporting documentation.
- Assess claims to ensure alignment with policy coverage and company guidelines.
- Verify supporting documents for accuracy and completeness of claim quantum.
- Maintain document diaries on the IMS system.
- Update reserves in line with company reserving policies.
- Follow up on outstanding documentation and proof of quantum.
- Exercise sound judgment to assess claims exposure and determine appropriate settlement within delegated authority.
- Approve claims after full verification and validation under policy terms.
- Escalate complex or disputed claims to the Supervisor.
- Coordinate with external stakeholders to ensure claims are handled according to procedures and company standards.
- Maintain accurate and up-to-date system notes reflecting claim progress.
- Report policy gaps, missing documentation, and premium adjustments to the underwriting department.
- Respond to customer queries promptly and in accordance with policy guidelines.
2. Agency / Broker Liaison
- Negotiate claim settlements effectively.
- Liaise with agents and brokers regarding claim progress.
- Provide regular updates to all relevant stakeholders.
3. Ad Hoc Duties
- Perform additional tasks as reasonably required by the Line Manager.
Desired Experience & Qualifications
- No prior experience required (entry-level position).
Package & Remuneration
- Salary: R12,500 per month
