Senior Claims Specialist - SHA

RESPONSIBILITIES

Claims Leadership

• Continuously mentor and train team members in line with legal developments and new products.
• Adhere to company claims reserving philosophy and standards.
• Develop, document, and execute claims strategies, considering uncertainties, key decisions, potential outcomes, and estimated costs.
• Learn, understand and implement the “Treating Customers Fairly” doctrine.

Claims Portfolio Management

• Manage claims portfolios to optimize performance and client satisfaction.
• Regularly review individual claims and update reserves and records as required by company controls and standards.
• Apply thorough policy knowledge to claims.
• Demonstrate extensive legal expertise in handling complex liability claims.
• Address internal and external complaints, including National Financial Ombud (NFO) complaints.

Collaboration with Underwriters

• Understand marketing and underwriting strategies for the business area.
• Contribute to business development and renewal opportunities by attending client meetings, explaining claims philosophy and approach, and discussing claims issues.
• Provide input to underwriters on potential or existing insureds’ claims experience.
• Offer feedback on claims trends and developments and their impact on the book.
• Suggest improvements to policy wording.

Authority and Compliance

• Operate within approved claims authority at all times.
• Implement minimum operating and claim standards.
• Maintain thorough knowledge of industry regulations and standards to ensure compliance with company claims and underwriting protocols.

Third-Party Management

• Follow company procedures for selecting and retaining third-party professionals and manage these relationships effectively.
• Conduct claim file reviews or audits and resolve identified issues.

Broker and Insured Relations

• Proactively develop and manage strong relationships with key brokers and insureds.
• Promote the company brand of excellence and professionalism in client service.

Conflict of Interest

• Adhere to the company’s Conflicts of Interest policy, promptly alerting the appropriate person to any potential conflicts and taking steps to resolve them.
• Immediately advise the Head of Department if any employee seeks to exert undue influence on claim management, reserving, or settlement.

People Management

• Guide staff on claims-related and other issues.
• Support training and development to help staff reach their full potential.
• Foster teamwork to promote a healthy and engaged workforce.
• Audit claims files as required.

Client Liaison (Internal and External)

• Respond to queries and resolve issues within the scope of authority and responsibility.
• Prepare for and attend meetings.

GENERAL ADMINISTRATOR

• Produce reports as required.
• Complete daily administrative tasks in accordance with organizational standards, processes, and procedures.
• Handle general correspondence as necessary.

QUALIFICATIONS and EXPERIENCE

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

Experience 
• Previous casualty claims handling experience 

Specific 
• Ability to strategise and drive a claim to finality 

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!