Head, Claims

Key Responsibilities:

Claims Management:

• Develop and implement claims management policies and procedures to streamline processes and improve operational efficiency.
• Ensure all claims are managed within authority limits, in line with claims standards, procedures and guidelines.
• Settle standard claims through payment or denial
• Negotiate to ensure efficient and competitive settlement.
• Oversee the entire claims lifecycle, from first notification of loss to final settlement, ensuring timely resolution in line with company standards.
• Determine appropriate reserving levels in alignment with organization’s standards.
• Ensure accurate claims assessments and evaluations to prevent fraud and minimize loss.
• Monitor and manage large or complex claims, providing guidance and approval as needed.

Survey Management:

• Direct and coordinate the activities of surveyors, ensuring accurate and thorough assessment of insured properties and damages.
• Develop and implement survey protocols and guidelines to ensure consistency, accuracy, and quality in survey reports.
• Investigate standard claims. including coverage determination and evaluation of loss exposures
• Ensure that surveys and inspections are conducted accurately and in a timely manner.
• Work with underwriting and risk teams to provide feedback from surveys that can improve underwriting guidelines.

Risk Control and Compliance:

• Implement and maintain quality control measures to ensure compliance with industry regulations and internal policies.
• Identify and manage claims risks by setting exposure limits and establishing fraud detection protocols.
• Ensure claims handling practices align with regulatory requirements and ethical standards.
• Ensure compliance with regulatory standards and internal policies.

Customer Experience and Communication:

• Ensure a customer-centric approach to claims handling, maintaining open communication channels with claimants throughout the process.
• Resolve escalated customer complaints promptly to ensure elevated levels of customer satisfaction and retention.
• Develop claims communication materials to enhance policyholder understanding of the claims process.

Data Analysis and Reporting:

• Regularly review and analyze claims data to identify trends, improve processes, and manage claims costs.
• Prepare and present regular claims performance reports, including key metrics such as turnaround times, settlement amounts and outstanding liabilities.
• Collaborate with finance and actuarial teams to support accurate loss reserves and forecasting.

Team Leadership and Development:

• Lead, mentor, and develop team members promoting a high-performance culture.
• Conduct regular performance appraisals, set goals, and identify training needs for the claims and survey teams.
• Foster a collaborative environment, coordinating with other departments such as underwriting, legal, and risk to enhance overall claims management effectiveness.
• Identify training needs within the claims team and provide ongoing development plans to improve skills and knowledge.

What will Make you Succeed?

Technical Competencies:

• Excellent business acumen
• Risk assessment/analysis.
• Product Knowledge
• Claims Adjustment
• Claims processing and administration
• Settlement and control
• Claims investigation & loss evaluation

Leadership Competencies:

• Strategic Thinking
• Change Management
• Ability to influence others towards desired outcomes
• Performance Management
• People Development

Personal Competencies:

• Adaptability
• Emotional Intelligence
• Communication, relationship building and negotiation skills.
• Complex problem solving and decision-making skills.

Academic and Professional Qualifications Required:

• 8-10 years practical experience in the insurance industry
• Academic qualifications up to a second-degree level in insurance, risk management, management and leadership, finance etc.
• Chartered Insurer

Key Relationships:

• Finance, Underwriting and Sales team
• External Surveyors
• Customers

Responsibility for Assets: The head, claims and survey will have custody of the Claims Bordeaux, Customer information, and any other assets necessary for the discharge of responsibilities.

Reporting Relationship: Executive, Corporate & Commercial

Location: Head office

Salary: Attractive

Employment type: Full Time