Claims Specialist - SHA

RESPONSIBILITIES

Claims Practice Management 

• Attend and manage all aspects related to a portfolio of specialist claims such as claims registration, case management, drafting, diary, recoveries, and settlement negotiations.
• Draft settlement agreements and other legal documents within mandate as per the Claims Governance Folder.
• Strategically manage a portfolio of claims.
• Manage loss adjusters and attorneys appointment on matters and ensure compliance with agreed service level agreements.
• Manage system processing and compliance with systems by way of payments, updating signed off reserves, proper recordal of information etc.
• Attend to Operational duties as allocated
• Compile and manage risk reports when required
• Actively manage and record claims above certain thresholds as per The Claims Governance Folder and report on matters to Claims Co and Executive where required.
• Comply with internal and external regulatory framework and internal and external processes and procedures in accordance with organisational standards.
• Draft processes and procedures that are compliant with relevant regulatory framework and applicable legislation.
• Effectively liaise and interact with Underwriters. 

Analysis

• Consider, analyse and interpret insurance policy and the contractual impact thereof for the determination of coverage;
• Critically analyse the facts of the matter and their impact on the underlying policy.
• Draft opinions on the interpretation of coverage in relation to the facts and the applicable policy, present and motivate;
• Draft opinions on merits and quantum of matter with the relevant caselaw and legislation applicable;
• Apply critical thinking to ensure appropriate decisions on merits, quantum and policy response.
• Critically consider and evaluate information provided and identify information required.
• Conduct a strategic assessment of claims and make strategic decisions and recommendations on handling of claims.
• Develop and maintain an understanding of technical and legal aspects impacting on the policy’s operation.
• Make representations and recommendations on improved wording and trends identification to underwriters

Individual Claims Leadership

• Be involved in continuous training and development in respect of Case Law, Policy wording, etc.
• Assist in identifying and developing SOP’s and processes to ensure claims department effectiveness.
• Take initiative in creating opportunities of interaction with Brokers and Insureds. 

Client Liaison (Internal and External)

• Liaise with clients to resolve queries to the satisfaction of the affected parties within the scope of authority and / or responsibility.
• Prepare for and attend meetings and consultation with brokers, insureds, legal representatives and loss adjusters.

GENERIC

• Administrative Skills
• Analysis and Judgement
• Attention to Detail
• Client Orientation
• Communication Skills including   negotiation
• Follow Up
• Initiative
• Interpersonal Skills
• Organisational Awareness
• Planning and Organising
• Teamwork
• Computer Literacy 

Build a successful career with us

Qualifications 

• Matric
• Law Degree
• Admitted attorney
• FAIS compliance a preference 

Specific

• Ability to strategise and drive a claim to finality 

Experience 

•  Previous casualty claims  handling experience 

Our commitment to transformation

Santam is the market leader in the general insurance industry in Southern Africa. As a large, diversified, and expanding company, we are committed to transformation and growth. While our headquarters are in South Africa, we are rapidly extending our presence into emerging markets across Africa and Asia.

With a client base of over 1 million policyholders, Santam serves individuals, commercial enterprises, specialist business owners, and institutions—including 80 of the Top 100 companies listed on the JSE. Our commitment to Insurance, Good and Proper goes beyond just providing cover—we offer peace of mind, ensuring our clients can focus on living in the moment, not worrying about the unexpected. Because at Santam, we believe the freedom to seize every day is worth protecting.

People drive our business, and we are committed to attracting the best talent, whether for permanent roles or short-term opportunities. 

Santam is committed to diversity, inclusion, and belonging. As an equal opportunity employer, we encourage applications from candidates of all backgrounds, including persons with disabilities. We are dedicated to neuro-inclusivity and fostering a workplace where everyone can thrive. 

Take the next step in your career—apply now and be part of a company that’s shaping the future of insurance. This is Freedom!