Claims Manager in the DRC in Congo

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City of Tshwane, Abroad
Our Client is part of an international insurance group operating in various territories throughout Africa. We are a highly respected group that is recognised for service excellence in African and International Markets. The group is experiencing expansion across the continent and will hire outstanding individuals to continue the planned growth strategy,looking to appoint a Claims manager to take responsibility for the handling, negotiation and processing of Corporate and Commercial Insurance Claims, including Motor & Workmen’s compensation claims.

Minimum Requirements:

Excellent communication skills with clear spoken and written formal English coupled with strong knowledge of MS Word & Excel are required. French will be advantageous.
Relevant market experience of minimum 5 years is preferable. Candidates applying for this position needs to be disciplined, presentable, self-motivated and possess strong time management skills. Work is driven by an internal system and requires an analytical mind.

Core Tasks:

Manage, Mentor, instruct and direct staff regarding proper claims handling and processing.
Ensure that all losses or possible losses are proactively recorded and processed in accordance with the company’s principles and procedures and to maintain files within Company service standards.
Ensure the timeous processing of claims on the Insurance administration system (KIT) within company set minimum service standards ;
To ensure that all files are reserved accurately and promptly within the Company’s reserving philosophy.
To be personally responsible for accurate reserving and quantification of claims reserves;
Ensure the processing of payments on claims files as required and in accordance with your authorities;
Review losses and instructing Loss Adjusters as required.
Investigate and Negotiate claim settlements within mandates.
To be aware of fraud indicators and potential fraudulent claims and seek guidance if required
To dispose of salvage in accordance with the agreed categories and our salvage contract terms
Identify and effect all potential recoveries from the relevant parties
Maintain diary within service level expectations and undertake regular file reviews to ensure effective and timely settlement of all claims
To ensure compliance with company standards/regulations at all times
Screening & distribution of incoming mail.
Authorize all high value and investigative authority requests above the claims representative authority level.
Conduct scheduled and periodic file reviews to ensure compliance with company standards.
Attend to claims queries which escalate to management level or are in need of management intervention.
Recognize and communicate all state and regulatory issues to staff members.
Train and monitor team member’s performance and provide leadership to the team.
Develop and manage a panel of service providers necessary for efficient claims handling.
Liaise with service providers and monitor service levels.
Liaise with staff and internal departments and monitor service levels.
Loss ratio monitoring.
Excellent organizational, time management & personal computer skills.
Demonstrated decision making & problem solving skills.
Ability to work under pressure.
Development and maintenance of relationships with Brokers, Clients & Reinsurers;
Liaison / negotiation with Reinsurers on all claims recoveries in line with company standards and relevant mandates and authorities;
Assisting in conducting pre loss surveys on request from the underwriting and new business departments;
Referring and corresponding with Head office on all matters outside of set authorities and mandates;
Facilitate and assist with queries from the Underwriting, Marketing, re-insurance and accounts departments.
Responsible for monthly reporting on Claims, Loss ratios and the like to the EXCO.
Always adhering to Service level standards as set and adjusted from time to time by the company.
If you feel you have the relevant skill set and are keen to be considered please send us your CV today to Fax :086 602 2008

Posted on : 05/12/2016, #, Edit

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