Claims Officer - Non-Motor

A dynamic organization in the General Insurance industry is seeking to fill the position of Claims Officer - Non Motor. The incumbent is expected to handle all aspects of insurance claims from first notice to final payment.

CORE FUNCTIONS

• Investigate and process claims in accordance with regulatory and company guidelines and requirements;
• Evaluate claims, establish and maintain reserves and settle claims;
• Ensure compliance with timelines established in company policies and procedures;
• Provide exceptional service to external and internal customers and act as a resource within the company;
• Respond to telephone and written correspondence from claimants, attorneys, physicians, clients and other related parties;
• Update company’s core computer system with all pertinent information for assigned claims;
• Conduct settlement negotiations with insured party, claimants and attorneys under guidance from Claims Team Leader and/or Head of Claims;
• Exercise sound decision-making on claims assigned, using knowledge of applicable codes, laws, standards and case law;
• Prepare payment requisitions;
• Appoint and work with loss adjusters/assessors, investigators and other external service providers as necessary;
• Liaise with intermediaries, branches, Underwriting and Accounts, and other government agencies to ensure timely resolution of claims;
• Make decisions on denial of coverage, liability or compensability and convey denials;
• Recognise settlement or exposure value and use tools such as structured settlements, arbitration and mediation to assist to settle cases;
• Perform own filing functions and keep all files in good order and appropriately filed in designated areas;
• Perform special projects and other job duties as necessary.