Claims Resolution Specialist Motor & Non-Motor (Short Term Insurance)

At Absa, a prominent African financial institution with a rich heritage spanning over a century, we are dedicated to shaping a brighter future for the continent. Our journey is one of continuous growth, innovation, and a commitment to empowering our communities. We are currently seeking a dedicated and experienced Claims Resolution Specialist to join our Short-Term Insurance division in Johannesburg. This role is crucial in ensuring our clients receive exceptional service and fair outcomes during their claims journey.

About the Role

As a Claims Resolution Specialist within our Short-Term Insurance team, you will be instrumental in managing the entire lifecycle of insurance claims. This includes both motor and non-motor claims, requiring a thorough understanding of short-term insurance principles and products. You will be the primary point of contact for clients, guiding them through a often stressful process with professionalism and empathy. The position demands meticulous attention to detail in assessing claims against policy provisions, regulatory frameworks, and internal service standards. It’s a dynamic environment where sound decision-making and effective stakeholder engagement are paramount to success.

Your responsibilities will encompass the full spectrum of claims management, from the initial notification of a claim through to its final resolution. This involves:

• **Claims Assessment and Processing:** Evaluating the validity of claims by carefully examining policy terms, conditions, and underwriting guidelines. You will be responsible for the accurate and timely processing of claims, ensuring all actions align with agreed-upon service levels.
• **Investigation and Validation:** Conducting investigations to validate claim legitimacy and identifying any potential indicators of risk or fraudulent activity.
• **Stakeholder Liaison:** Collaborating effectively with a range of internal and external parties, including assessors, loss adjusters, service providers, and legal representatives, to facilitate efficient claims handling.
• **Client Service Excellence:** Providing compassionate and professional support to clients throughout the claims process. This includes clearly communicating claim decisions and outcomes. You will also manage more complex or escalated claims, ensuring a consistently high level of customer satisfaction.
• **Relationship Management:** Building and nurturing strong, positive relationships with both internal teams and external partners.
• **Risk and Compliance:** Ensuring strict adherence to all relevant regulatory requirements, including FAIS (Financial Advisory and Intermediary Services) and TCF (Treating Customers Fairly) principles. Maintaining comprehensive and audit-ready documentation for all claims is essential.
• **Process Improvement:** Contributing to ongoing initiatives aimed at enhancing claims processes and operational efficiency. Identifying trends and opportunities to mitigate risks and improve service delivery will be a key aspect of the role.

What They're Looking For

To excel in this role, you will need a solid foundation in short-term insurance claims, coupled with strong interpersonal and analytical skills. The ideal candidate will possess:

• A Grade 12 certificate (Matric) is a fundamental requirement.
• A minimum of 3 to 5 years of dedicated experience in the short-term insurance claims environment.
• Proven experience in handling both motor and non-motor insurance claims.
• A deep understanding of policy interpretation and the nuances of claims assessment.
• A comprehensive grasp of regulatory and compliance mandates applicable to the insurance industry.
• Exceptional communication and negotiation abilities, allowing you to interact effectively with clients and stakeholders.
• Proficiency in using claims management systems and the Microsoft Office Suite.
• While not strictly mandatory, relevant insurance qualifications and RE5 certification are advantageous. A FAIS-compliant qualification would also be a significant asset.

This position offers a rewarding opportunity to contribute to a leading financial institution while developing your career in the vital field of insurance claims resolution.

In South Africa, the role of a Claims Resolution Specialist is a well-established and critical function within the insurance sector. Depending on experience and the complexity of the claims handled, salaries for such positions can range from R20,000 to R40,000 per month, with potential for higher earnings in more senior or specialised roles. Major insurance companies, banking groups with insurance arms like Absa, and dedicated short-term insurance providers are common employers. Career progression often involves moving into more senior claims roles, team leadership, or specialising in specific types of claims or risk management within the insurance value chain.

Minimum Requirements

• Matric (Grade 12) essential

• Relevant Insurance Qualification advantageous

• RE5 Certification preferred

• FAIS-compliant qualification advantageous

• Minimum 3-5 years' experience in Short-Term Insurance Claims

• Experience handling motor and/or non-motor claims

• Knowledge of policy interpretation and claims assessment

• Strong understanding of regulatory and compliance requirements

• Excellent communication and negotiation skills

• Proficient in claims management systems and Microsoft Office Suite

Key Responsibilities

Claims Management

• Manage claims from first notification through to final settlement.

• Assess claims in accordance with policy terms, conditions, and underwriting guidelines.

• Investigate claim validity and identify potential risk or fraud indicators.

• Ensure accurate and timely processing of claims within agreed service standards.

• Liaise with assessors, loss adjusters, service providers, and legal representatives where required.

Client Experience

• Provide professional and empathetic support to clients throughout the claims process.

• Communicate claim outcomes clearly and effectively.

• Manage complex and escalated claims whilst maintaining high levels of customer satisfaction.

• Build and maintain strong relationships with internal and external stakeholders.

Risk & Compliance

• Ensure adherence to FAIS, TCF, and other regulatory requirements.

• Maintain accurate claims documentation and audit-ready records.

• Identify trends and opportunities to mitigate risk and improve claims processes.

• Escalate high-risk matters in accordance with internal governance frameworks.

Operational Excellence

• Contribute to continuous process improvement initiatives.

• Meet productivity, quality, and customer service targets.

• Support business objectives by delivering efficient and effective claims solutions.

• Participate in training, coaching, and knowledge-sharing initiatives.

 Claims assessment: Assess and/or process claims following standard operating procedures | Customer Experience: Handle all customer interactions professionally and efficiently | Ad Hoc duties: Provide support to customers and team as required to ensure team performance on an ongoing basis | Compliance and Risk Management: Ensure that all team activities are in adherence to relevant control and compliance requirements, and quality standards

Education

Further Education and Training Certificate (FETC): Business, Commerce and Management Studies (Required)

Absa Bank Limited is an equal opportunity, affirmative action employer. In compliance with the Employment Equity Act 55 of 1998, preference will be given to suitable candidates from designated groups whose appointments will contribute towards achievement of equitable demographic representation of our workforce profile and add to the diversity of the Bank.

Absa Bank Limited reserves the right not to make an appointment to the post as advertised