Claims Specialist

Claims Specialist

Claims Specialist

Huntswood
Durban, KwaZulu-Natal
Permanent
Posted: 29 April 2026
Closing Date: 08 May 2026


Role Overview

An established insurance services organisation is seeking a detail-driven and experienced Claims Specialist to manage a diverse portfolio of insurance claims. This role focuses on Accidental Damage (AD), Third-Party liability, and recovery claims, with responsibility for investigation, assessment, negotiation, and resolution.

The successful candidate will play a key role in ensuring fair outcomes, strong customer service, and effective claims management in line with policy and compliance standards.


Key Purpose of the Role

To independently manage insurance claims from start to resolution, ensuring accurate assessment, effective investigation, and timely settlement while maximising recoveries and maintaining high service standards.


Key Responsibilities

Claims Management

  • Manage a portfolio of AD, third-party liability, and recovery claims
  • Investigate claim circumstances and assess liability
  • Review and validate supporting evidence and documentation
  • Ensure accurate interpretation of policy terms and conditions

Customer & Stakeholder Engagement

  • Communicate professionally with customers, insurers, brokers, and third parties
  • Handle complex queries, disputes, and complaints effectively
  • Provide clear and fair explanations of claim decisions

Recoveries & Negotiation

  • Drive recovery processes and pursue cost recovery opportunities
  • Negotiate settlements to maximise business value
  • Liaise with third parties and service providers to conclude claims

Administration & Compliance

  • Maintain accurate, detailed, and compliant case records
  • Ensure all claims are processed in line with regulatory and internal requirements
  • Meet service level agreements (SLAs) and turnaround times
  • Ensure proper documentation and audit readiness

Performance Delivery

  • Deliver high-quality claim decisions with speed and accuracy
  • Manage workload effectively under pressure
  • Contribute to operational efficiency and continuous improvement

Minimum Requirements

  • Grade 12 / Matric (NQF Level 4 equivalent)
  • 1–3 years’ experience in the insurance industry
  • Experience in claims handling (motor insurance advantageous)
  • Exposure to AD claims, third-party liability, and/or recoveries
  • Strong communication and negotiation skills
  • Ability to analyse information and investigate claims
  • Comfortable working in a high-pressure, SLA-driven environment
  • Proficient in Microsoft Office

Key Competencies

  • Strong investigative and analytical thinking
  • Attention to detail and accuracy
  • Customer-focused mindset
  • Problem-solving and decision-making ability
  • Time management and prioritisation skills
  • Professional communication (written and verbal)
  • Accountability and ownership of work
  • Ability to work independently and in a team

What the Role Offers

  • Fully covered medical insurance
  • Performance-based incentives
  • Tenure and attendance bonuses
  • Weekly support initiatives (breakfasts and employee care packs)
  • Structured learning and career development opportunities
  • A collaborative, people-focused working environment

Core Behaviours Expected

  • Ownership of tasks and outcomes
  • Strong service orientation with a focus on customer experience
  • Integrity and ethical decision-making
  • Team collaboration and support for others
  • Continuous improvement mindset
  • Resilience and ability to perform under pressure
  • Positive, high-performance attitude

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