Claims Examiner - A&H

Posted:
10/28/2024, 11:57:26 AM

Location(s):
Johannesburg, Gauteng, South Africa ⋅ Gauteng, South Africa

Experience Level(s):
Junior ⋅ Mid Level

Field(s):
Customer Success & Support ⋅ Legal & Compliance ⋅ Sales & Account Management

Provide an efficient and professional Claims service to customers through prompt and fair settlement of Claims within mandate.

Contribute to business development and retention through positioning Claims and Claims service as an AIG product.

PRINCIPLE DUTIES AND RESPONSIBILITIES:

Claims Administration

  • Register the Claim according to procedure

  • Set appropriate reserves in line with policy

  • Determine if the loss is covered in terms of the policy

  • Assess the Claim based on accurate interpretation of policy wording in place: refer Claims outside Claims mandate

  • Appoint / recommend appointment of loss adjusters and/or relevant experts: provide appropriate settlement instructions

  • Follow Claims settlement process to ensure timely settlement of Claims and fees

  • Conduct timely, professional follow-up correspondence with Clients and Brokers, including Claims rejection

  • Provide reports to Claims Manager in line with Claims policies

Customer Service

  • Establish and maintain excellent levels of customer service, with particular attention to:

  • Responsiveness – speed of service delivery

  • Quality of service rendered

  • Adherence to internal and external SLA’s

Expense control

  • Manage all expenses within budget. Continuously work to reduce the expense ratio through constant attention to efficiencies and opportunities to maximize productivity through streamlining of processes

Audit and Compliance

  • Ensure adherence with and implementation of all claims compliance controls as may be specified from time to time by the Claims Manager.

What we’re looking for:

Qualification

  • Matric

  • Short Term Insurance qualification preferred

  • FAIS compliant

Experience

Minimum of 3 year’s experience as Claims Examiner, including experience in specific Line of Business, as appropriate.

Core Competencies Requirements:

  • Dealing with Ambiguity

  • Customer Focus

  • Negotiating

  • Drive for Results

  • Business Acumen

  • Problem Solving

  • Interpretation of legal agreements

  • Policies for Regulations

  • Portfolio Management

Reimagining insurance to make a bigger difference to the world

American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world’s most far-reaching property casualty networks. It is an exciting time to join us — across our operations, we are thinking in new and innovative ways to deliver ever-better solutions to our customers. At AIG, you can go further to support individuals, businesses, and communities, helping them to manage risk, respond to times of uncertainty and discover new potential. We invest in our largest asset, our people, through continuous learning and development, in a culture that celebrates everyone for who they are and what they want to become.

Welcome to a culture of belonging

We’re committed to creating a culture that truly respects and celebrates each other’s talents, backgrounds, cultures, opinions and goals. We foster a culture of inclusion and belonging through our flexible work arrangements, diversity and inclusion learning, cultural awareness activities and Employee Resource Groups (ERGs). With global chapters, ERGs are a cornerstone for our culture of inclusion. The diversity of our people is one of AIG’s greatest assets, and we are honored that our drive for positive change has been recognized by numerous recent awards and accreditations.

AIG provides equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories.

AIG is committed to working with and providing reasonable accommodations to job applicants and employees with disabilities.  If you believe you need a reasonable accommodation, please send an email to [email protected].  

Preference will be given to previously disadvantaged candidates in line with the company’s Employment Equity Plan. Specific preference will be given to people with disabilities.

Functional Area:

CL - Claims

AIG South Africa

American International Group

Website: https://aig.com/

Headquarter Location: New York, New York, United States

Employee Count: 10001+

Year Founded: 1919

IPO Status: Public

Industries: Commercial Insurance ⋅ Financial Services ⋅ Health Insurance ⋅ Insurance ⋅ Lending ⋅ Life Insurance ⋅ Property Insurance ⋅ Real Estate Investment ⋅ Retirement ⋅ Risk Management