Claims Manager-JG7-JHB

Role Purpose

Kandua is seeking an experienced Non-motor Claims Manager to provide operational and technical leadership to its growing non-motor claims function.
The Claims Manager will be responsible for guiding the claims team, maintaining consistent claims handling standards and ensuring that claims are delivered accurately, efficiently and in accordance with insurer mandates, service-level agreements and customer expectations.
This is a hands-on leadership role requiring substantial short-term insurance claims experience and demonstrable technical competence in plumbing, geyser, water-related, resultant damage and building claims. The successful candidate must be able to assess complex operational and technical claims matters, guide claim decisions, improve team performance and introduce the controls required to support increasing claims volumes.
The role operates at the intersection of claims operations, product, technology and Kandua’s national network of service providers.

 The Claims Manager will work closely with the Head of Operations, Claims Product Manager, operational teams, insurer stakeholders and Kandua Pros to ensure that the end-to-end claims process delivers appropriate indemnification, strong customer outcomes and sustainable commercial performance.

Key Responsibilities

1. Claims leadership and technical oversight

● Provide day-to-day leadership and technical guidance to the claims operations team.
● Oversee the appropriate validation, assessment, adjustment, quantification and resolution of non-motor claims.
● Guide the team on policy interpretation, indemnity, scope, settlement options and claims-handling decisions.
● Review complex, high-value, disputed or escalated claims and provide clear direction on the appropriate course of action.
● Ensure claims decisions are consistent with applicable insurer mandates, policies, procedures, regulatory requirements and delegated authorities.
● Maintain appropriate technical standards across simple plumbing, resultant damage and additional claims categories introduced by Kandua.
● Identify trends that could indicate leakage, fraud, over-servicing, under-scoping, poor workmanship or inconsistent decision-making.
● Act as the primary operational escalation point for difficult claims and technical claims queries.

2. Claims operations management

● Manage the end-to-end operational performance of the claims team.
● Ensure claims are progressed within agreed turnaround times and service-level agreements.
● Monitor workloads, team capacity, case allocation, ageing claims, backlogs and outstanding actions.
● Ensure operational issues are identified, analysed and resolved quickly.
● Introduce appropriate operating routines, controls, quality checks and escalation processes where these do not currently exist.
● Maintain visibility over claims from assignment through assessment, repair, documentation, invoicing and closure.
● Coordinate effectively with Operations, Finance, Product and the Pro network to reduce unnecessary rework and delays.
● Ensure that claims records, photographs, reports, quotations, invoices and supporting documentation are complete and accurate.
● Support business continuity and claims response during periods of increased demand or catastrophe events.

3. People leadership and performance management

● Lead, coach, support and develop the claims team.
● Establish clear responsibilities, performance expectations and service standards.
● Conduct regular one-on-ones, performance reviews, case reviews and coaching sessions.
● Ensure team members understand the technical, operational and customer-service requirements of their roles.
● Address underperformance, conduct and capability gaps promptly and fairly.
● Recognise and develop high-performing team members.
● Identify training requirements and implement structured technical and operational development plans.
● Build claims technical capability across the team.
● Build a disciplined, accountable and customer-focused claims culture.
● Support recruitment, onboarding and succession planning within the claims function.

4. Customer and stakeholder management

● Ensure customers receive professional, empathetic and timely communication throughout the lifecycle of a claim.
● Oversee the resolution of complaints and escalations, ensuring that matters are resolved fairly and promptly.
● Build strong working relationships with insurer claims teams, assessors, service providers, internal stakeholders and other claims partners.
● Participate in insurer governance meetings and operational reviews when required.
● Present claims performance, risks, service issues and corrective actions clearly to internal and external stakeholders.
● Ensure that stakeholder commitments are tracked and delivered.
● Protect Kandua’s reputation by maintaining high standards of service, communication and claims decision-making.

5. Pro and service-provider performance

● Work with the Pro and Operations teams to ensure that claims are allocated to appropriately vetted, trained and capable service providers.
● Monitor Pro performance across workmanship, customer communication, turnaround times, documentation, quotation compliance, cancellations and escalations.
● Identify poor-performing service providers and recommend coaching, corrective action, suspension or removal where necessary.
● Support the prioritisation and increased allocation of work to consistently high-performing Pros.
● Ensure technical and claims-related training requirements are clearly communicated to the Pro network.
● Assist in resolving disputes involving scope, workmanship, pricing, documentation or payment.
● Support the development of consistent claims delivery standards across Kandua’s national supplier network.

6. Reporting, controls and governance

● Produce accurate and meaningful claims management reports.
● Monitor key operational, customer, financial and quality indicators.
● Identify trends, root causes, risks and opportunities from claims data.
● Establish and maintain appropriate claims controls, audit trails and quality-assurance processes.
● Ensure adherence to insurer mandates, delegated authorities, service-level agreements and Kandua procedures.
● Track corrective actions arising from audits, complaints, governance reviews and operational incidents.
● Ensure that claims leakage, recoveries, duplicated costs, inappropriate settlements and avoidable rework are identified and addressed.
● Support accurate financial reconciliation between claims operations, Pros, insurers and Finance.
● Escalate material risks, control failures and service concerns to the Head of Operations and Claims Product Manager.

7. Process, product and technology improvement

● Work closely with the Claims Product Manager to translate operational requirements into product and system improvements.
● Identify manual processes, bottlenecks and control weaknesses that can be addressed through automation.
● Participate in the design, testing and implementation of claims workflows, dashboards, decision tools and system enhancements.
● Ensure that operational teams adopt and correctly use new processes and technology.
● Provide structured feedback on user experience, workflow performance and claims data quality.
● Support Kandua’s objective of increasing the proportion of claims processed through standardised and automated workflows.
● Help establish scalable claims processes that can support new insurers, claim types, geographic regions and commercial partnerships.
● Promote the responsible use of data, analytics and AI to improve efficiency, quality and decision-making.

Qualifications

● Grade 12 or equivalent.
● A recognised short-term insurance or claims qualification.
● Strong working knowledge of South African non-motor insurance claims.
● Relevant regulatory and industry requirements applicable to claims handling.
● Experience in plumbing, resultant damage, building or household claims advantagious.
● Relevant bachelor’s degree, technical diploma or equivalent tertiary qualification advantagious.
● Insurance Institute of South Africa or similar industry qualification advantagious.
● Qualification relating to loss adjusting, building, plumbing, construction, engineering or property assessment advantagious.
● FAIS-related qualifications or regulatory examinations, where applicable advantagious.

Experience

● At least 5 years' experience leading or managing a team, of which a minimum of 3 years in a plumbing or building claims-specific management role.
● At least 8 years’ experience in a short-term insurance claims environment.
● At least 5 years’ direct experience in non-motor or property claims.
● At least 3 years’ experience leading or managing a claims or operational team.
● Demonstrated experience building or materially improving high-volume claims processes and leading the team through change.
● Experience reviewing complex claims and providing technical claims guidance.
● Proven experience in performance management, coaching and staff development.
● Experience working against insurer mandates, delegated authorities and service-level agreements.
● Experience managing complaints, escalations and sensitive customer matters.
● Experience interpreting claims data and presenting management reports.
● Experience working with assessors, contractors, repair networks or outsourced claims service providers.

Personal Atrributes

● experienced and credible within the claims environment;
● calm and decisive under pressure;
● structured and operationally disciplined;
● technically confident without being inflexible;
● comfortable challenging poor decisions or weak controls;
● able to move between detailed case management and broader operational leadership;
● highly accountable;
● customer-focused;
● commercially aware;
● collaborative and pragmatic; and
● motivated by building a scalable, technology-enabled claims operation.

Knowledge and Technical Skills

● non-motor and property claims processes;
● Technical knowledge about plumbing and building repairs, SANS / Building regulations
● policy interpretation, validation and indemnification;
● claims assessment, adjustment and quantification in building and plumbing repair methodology, scoping and pricing;
● settlement methods and claims authorities;
● claims leakage and cost control;
● complaints and escalation management;
● claims governance and regulatory compliance;
● service-provider and contractor management;
● claims quality assurance;
● operational reporting and data interpretation;
● customer-service standards;
● performance and capacity management; and
● workflow automation and claims technology.

Leardership Competencies

● Claims judgement: Makes technically sound, fair and commercially responsible claims decisions.
● Operational leadership: Establishes discipline, structure and accountability in a high-volume environment.
● People leadership: Coaches teams, addresses underperformance and builds capability.
● Customer focus: Balances technical claims requirements with fair and empathetic customer treatment.
● Commercial orientation: Understands how claims decisions, leakage, service quality and operational efficiency affect business performance.
● Decision-making: Acts decisively and appropriately when faced with incomplete information or operational pressure.
● Change leadership: Helps teams adopt new technology, processes and ways of working.
● Collaboration: Works effectively across Claims, Operations, Product, Finance, Pro and insurer teams.
● Continuous improvement: Uses data and operational insight to improve quality, efficiency and scalability.
● Integrity: Applies policy, process and delegated authority consistently and transparently.

Personal Attributes

● experienced and credible within the claims environment;
● calm and decisive under pressure;
● structured and operationally disciplined;
● technically confident without being inflexible;
● comfortable challenging poor decisions or weak controls;
● able to move between detailed case management and broader operational leadership;
● highly accountable;
● customer-focused;
● commercially aware;
● collaborative and pragmatic; and
● motivated by building a scalable, technology-enabled claims operation.

Key Working Relationships

Internal
● Head of Operations
● Claims Product Manager
● Claims Operations team
● Pro Operations and Pro Management teams
● Product and Engineering teams
● Finance team
● Commercial and Partnerships teams
● Kandua leadership team

External

● Santam and other insurer claims stakeholders
● Policyholders and homeowners
● Assessors and loss adjusters
● Kandua Pros and service-provider businesses
● Suppliers and claims technology partners
● Industry and regulatory stakeholders, where applicable

Build a successful career with us

We’re all about building strong, lasting relationships with our employees. We know that you have hopes for your future – your career, your personal development and of achieving great things. We pride ourselves in helping  our employees to realise their worth. Through its five business clusters – Sanlam Fintech, Sanlam Life and Savings, Sanlam Investment Group, Sanlam Allianz, Santam, as well as MiWay and the Group Office – the group provides many opportunities for growth and development.

Turnaround time

The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of managers. 

About Kandua

Kandua is a technology-enabled services platform that connects insurers, businesses and homeowners with vetted service professionals.
Within claims, Kandua manages the operational journey from claim allocation and customer contact through assessment, service delivery, documentation and closure. Kandua combines claims operations, technology, data and a national network of Pros to provide insurers and their customers with a consistent and scalable service.
The Claims Manager will play a central role in strengthening Kandua’s claims capability as the business increases volumes, introduces additional claim types and expands its insurer and commercial partnerships.