Job Description

CAREER OPPORTUNITY
This career opportunity is available at Tailored Claims Solutions for the Client Service Manager, who will be based in the Glacier Building, Belville.
WHAT WILL YOU DO?
The purpose of this role is to be Chair for the Claims committee which reviews claims that are rejected. Resolve and formulate responses to complaints received from Clients/Ombudsman/Internal Arbitrator /Client Care /Claims Advocacy team. Provide assistance in specialist technical support to the adjuster and skills development through on the job training /peer coaching. The responsibilities will include resolving disputes involving claims adjustments and negotiations with the insured and or broker after failed attempts by the Adjuster, Claims Service Consultant and Team Manager. Escalating unresolved claims issues to the relevant Manager.
WHAT WILL MAKE YOU SUCCESSFUL IN THE ROLE?

• Providing formal responses to matters referred to Ombudsman/Internal Arbitrator/Client Care/Claims advocacy.
• Chair claims committee which determines whether claims are invalid or not (rejections).
• Formulating responses to clients disputing rejections /review rejections
• Continuous technical guidance and support and up skill and behaviour needs of external adjuster /internal adjusters/claims service consultants.
• To curb Lost Economic Opportunity (LEO)
• Liaise with Training and Technical Advice.
• On the job and peer coaching
• Client Service Manager will meet with the client at the client's premises on request to address contentious matters. This meeting may include the broker as well as the relevant authorised supplier(s) appointed in the claim.
• Resolving disputes where claims service consultant's and team manager's resources are exhausted.
• Ensures adherence to claims policy and philosophy.
• Distribute Ombudsman Rulings and Claims Technical advice interpretations.
• Single point of entry to Claims Technical Advice
• Technical Policy interpretations and liaison with business units
• Feedback to underwriters regarding policy wording reviews
• Claims complaints must be addressed to the relevant manager.
• Standing in for the relevant manager in his/her absence, when on leave or study leave, refer to Operations Manager Continuous technical guidance and support and up skill and behaviour needs of the Assessors.
• Regular liaison with management and staff at all levels of the company regarding escalated claims/ flagged.
• Consultation with clients, Business and Business Partners on a continuous basis regarding fraud and irregularities
• Regular liaison with counterparts at other insurers
• Regular liaison with Santam Forensic Services.
• Effective relationships with law enforcement and Insurance Crime Bureau, South African police Services National Prosecutions Authorities, Suppliers, Wreck dealers, Brokers, Broker Consultants and Area managers.

QUALIFICATIONS AND EXPERIENCE

• Matric/ Grade 12.
• A post matric qualification
• Post graduate insurance or building industry related qualification.
• Must be computer literate (MS Word, MS Excel and MS Power Point)
• 7-10 years insurance experience in the Non-Motor and Motor claims environment with direct clients
• Insurance related training experience
• Building and related repairs quantification experience
• 2-3 years Management Experience
• Sound knowledge of the Santam Motor and Non-motor process
• Good verbal skills
• Working knowledge of the building industry (working in the industry would be preferable)
• Customer Centricity experience.
• Lean Six Sigma Certification-Green Belt an added benefit.

KNOWLEDGE AND SKILLS

• Good negotiating skills
• Problem solving skills
• Conflict resolution
• Good communication - verbal and writ
• Excellent interpersonal skills
• Strategic thinking
• Ability to influence

PERSONAL ATTRIBUTES

• Drives results
• Deciding and initiating action
• Leading and supervising
• Collaborates
• Client focus
• Flexibility and adaptability
• Cultivates innovation
• Strategic decision making
• Analytical thinking
• Influencing/ gaining commitment
• Business acumen
• Coaching and development

ABOUT THE COMPANY
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.