About the position
Purpose of the role:
Claims Consultant required to manage homeowners' claims from start to finish, ensuring fair, compliant outcomes while balancing customer care and risk management.
Reporting to the Claims Manager, the incumbent will be expected to deliver exceptional customer experience through the efficient, fair, and compliant management of homeowners' insurance claims. The role focuses on timely claim resolution, sound risk management, and consistent alignment with regulatory requirements and the company's service standards.
Requirements:
- Matric (Grade 12)
- FETC: Short-Term Insurance (NQF Level 4)
- RE5
- Minimum 4-5 years' short-term insurance experience, preferably in homeowners' claims
- Strong ability to interpret technical reports and communicate outcomes accurately to customers
- Strong technical claims judgement and problem-solving ability
- Short-term insurance and claims processing expertise
- Proficient in Microsoft Excel, Word, and Outlook, Google Maps
- Experience navigating claims management systems
- Ability to analyse and communicate technical information effectively
- Excellent verbal and written communication skills
- Ability to work under pressure, meet deadlines, and manage high workloads
- Ethical, decisive, confident, fair, and detail-oriented
- Strong sense of accountability and teamwork
Responsibilities:
Claims Processing:
- Claims Management and Technical Delivery:
- Assess, authorize, and resolve homeowners' claims within mandate, productivity targets and turnaround times
- Apply policy wording accurately to ensure fair, compliant claim outcomes
- Manage claim rejections, approvals, and settlements in line with regulatory requirements
- Appoint and manage appropriate relationships with various spectrum of panel approved experts and ensure correct application of building tariffs and rates
- Analyse reports and quotations to support prompt and informed decision-making
- Maintain accurate claim records using claims management systems and digital tools
Customer Experience and Communication:
- Deliver clear, professional, and empathetic communication throughout the claims journey
- Handle complaints and difficult customer interactions calmly, assertively, and fairly
- Explain technical claim outcomes to customers and stakeholders in a clear and accessible manner
Risk Awareness and Investigation:
- Analyse claims history and reported incidents to identify trends, risks, or anomalies
- Escalate suspicious or potentially fraudulent activity in line with internal processes
- Engage constructively with loss adjusters and technical specialists to debate and resolve complex claims
Stakeholder Engagement:
- Build and maintain strong working relationships across internal and external stakeholders
- Collaborate daily with Finance, Customer Contact Centre's, Policy Administration, Procurement, and Management
- Engage with service providers including loss adjusters, engineers, quantity surveyors, and forensic specialists
- Support internal and external audit processes as required
This role requires a strong commitment to ethical conduct, regulatory compliance, continuous learning, and personal accountability. You'll be expected to live the company values and actively invest in your professional growth.
Desired Skills:
- Claims
- Claims processing
- Building claims
- Claims handling
- Loss Adjusting
- Short term insurance
- Insurance Claim
- Policy administration
- Audit processes
- Risk identification
Desired Work Experience:
- 2 to 5 years Claims Assessment
Desired Qualification Level:
