Claims Consultant

Description:

The successful candidate will be responsible for delivering exceptional customer experiences by efficiently managing homeowners and buildings insurance claims from start to finish. This role balances timely and fair claim resolution with risk management, compliance, and service excellence, ensuring alignment with regulatory requirements and company standards.

Claims Management & Technical Delivery

• Assess, authorize, and resolve homeowners claims within mandate, productivity targets, and turnaround times

• Apply policy wording accurately to ensure fair and compliant claim outcomes

• Manage claim approvals, rejections, and settlements in line with regulatory requirements

• Appoint and manage relationships with panel-approved experts, ensuring correct application of building tariffs and rates

• Analyze reports and quotations to support prompt, informed decision-making

• Maintain accurate claim records using claims management systems and digital tools

  Customer Experience & 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 & Investigation

    • Analyze 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 Centres, 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

        Education Profile

        • Matric (Grade 12)
        • Minimum 4 years short-term insurance experience, preferably in homeowners claims
        • Strong ability to interpret technical reports and communicate outcomes accurately to customers
        • FETC: Short-Term Insurance (NQF Level 4)
        • RE5
        • Strong technical claims judgement and problem-solving ability
        • 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 a