Job PurposeThe Personal Lines Claims Manager will manage in-house claims and Third-Party Administrators with binder agreements authorised to process claims. Review any outsourced functions relating to personal lines claims including mandates. Collaborate on the Service Provider Panel and the Product development. Manage the reporting of average cost per claim targets, effective procurement utilisation, salvage, recoveries and authorisation of claims.Job ResponsibilitiesRefer high risk claims including multi-claimants and total lost to underwriting.Discuss proposed amendments to pricing models and new covers with Actuarial team based on claims experience.Build and maintain effective relationships with key stakeholders.Ensure compliance with underwriting guidelines.Quality monitoring and reporting on the selection of risks, classification and rating of risks.Managing the personal lines claims team (inhouse or outsourced).Identifying trends and recommending improvements - understanding the competitive landscape and client expectations.Ensure that procured service providers are utilised where applicable and cost, recoveries and salvage monitored, estimates and statuses are updated.Ensure that claim validations are being done in accordance with our mandate and the cover provided.Dealing with VIP clients, escalations and complaints.Risk management / self-identified risks as well as be part of the team who deals with auditors and other monitoring teams.Authorising claims and approving rejections.Reporting daily/weekly/ monthly - for the Claims pack to the Ops Manco.Adhering to binder claims mandates. Process all claims over partial binder mandate.Evaluate and investigate all claims received in order to prevent possible leakage to the company in the settlement of claims.Monitor claims SLA and ensure that transactions are processed within delegated authority limites and within set standards.Detection and management of fraud, dishonesty, misrepresentation.Work with the NI Claims Manager to roll out of the claim's philosopy and framework within team and binder holders.Managing rejections, ex-gratia claims (be part of the committee chaired by the NI Claims Manager) and ensuring fairness and diplomatic communication.Coordination of third-party recover/liability claims.
Responsibilities + Skills
Managing a team of managersBuilding a community of leadersDeveloping a departmental strategic planDeveloping resource plans to execute functional strategies
Matric / Grade 12 / National Senior CertificateAdvanced Diplomas/National 1st Degrees