Description

Job Description

To manage the claims division in manner that ensures that all claims received are processed in a timely and professional manner that systems and procedures covering claims are adhered to and customer service standards met.

Key Responsibilities

Claims Operations

• Lead and oversee the Claims Department to ensure timely, accurate and professional claims processing.
• Drive customer satisfaction, operational efficiency, claims cost control and compliance
• Ensure claims are processed and settled within agreed service standards.
• Implement and enforce claims policies, procedures and controls.
• Liaise with branches, customers, intermediaries and service providers on claims matters.
• Handle customer complaints and claims escalations.

Claims Governance & Risk

• Ensure compliance with company policies, regulatory requirements and AML standards.
• Monitor claims trends, fraud risks and loss control opportunities.
• Review and manage claims reserves to ensure accuracy.
• Recommend improvements to claims processes and policy wording

Financial Management

• Manage departmental budgets and operating costs.
• Monitor claims expenditure and control claims leakage.
• Ensure claims liabilities are accurately reflected.

Service Provider Management

• Manage relationships with assessors, investigators and other service providers.
• Monitor service levels and performance standards.

Leadership & People Management

• Lead, supervise, coach and develop claims staff.
• Set performance targets and monitor achievement.
• Conduct performance reviews and identify training needs.
• Foster a high-performance and customer-centric culture

Reporting & Stakeholder Management

• Prepare management reports on claims performance, costs and trends.
• Maintain strong relationships with customers, intermediaries, branches and regulators.
• Provide insights and recommendations to improve portfolio performance

ANTI-MONEY LAUNDERING (AML) EXPECTATION

The incumbent will be responsible for ensuring adherence to, implementation of, and adoption of Compliance, Anti-Money Laundering (AML), and Sanctions-related policies, procedures, and process requirements within Old Mutual and its subsidiaries. This includes execution of customer due diligence processes, ensuring compliance with Know-Your-Customer (KYC) standards, conducting ongoing and enhanced due diligence, and maintaining data quality. Additionally, the role involves identifying and monitoring potential AML, Sanctions, or Compliance breaches and unusual activities, and escalating these concerns to the Risk and Compliance Office for further action.

Qualifications:

• Bachelor’s degree in insurance, Business Administration, Actuarial Science, Statistics, Commerce, Finance or related field.
• Professional qualification such as ACII, ANZIIF or Advanced Diploma in Insurance.

Experience:

• Minimum 7 years’ experience in claims and/or underwriting.
• At least 3 years’ experience in a supervisory or management role

Skills And Competencies.

• Strategic thinking
• Computer skills
• Staff Supervision, training and performance management skills
• Leadership & People Management
• Analytical & Problem-Solving Skills
• Communication & Interpersonal Skills
• Customer Service Orientation
• Negotiation & Stakeholder Management
• Financial & Claims Management Skills
• Ability to work with minimum supervision

Skills

Claims Management, Customer Service Standards, Ensure Compliance, Financial Auditing, Insurance Claims Investigations, Policies & Procedures, Regulatory Requirements, Service Standards

Competencies

Business Insight

Collaborates

Communicates Effectively

Decision Quality

Directs Work

Ensures Accountability

Financial Acumen

Instills Trust

Education

Bachelors Degree (B): Actuarial Science, Bachelors Degree (B): Business Administration, Bachelors Degree (B): Finance

• Lead and oversee the Claims Department to ensure timely, accurate and professional claims processing.
• Drive customer satisfaction, operational efficiency, claims cost control and compliance
• Ensure claims are processed and settled within agreed service standards.
• Implement and enforce claims policies, procedures and controls.
• Liaise with branches, customers, intermediaries and service providers on claims matters.
• Handle customer complaints and claims escalations.
• Ensure compliance with company policies, regulatory requirements and AML standards.
• Monitor claims trends, fraud risks and loss control opportunities.
• Review and manage claims reserves to ensure accuracy.
• Recommend improvements to claims processes and policy wording
• Manage departmental budgets and operating costs.
• Monitor claims expenditure and control claims leakage.
• Ensure claims liabilities are accurately reflected.
• Manage relationships with assessors, investigators and other service providers.
• Monitor service levels and performance standards.
• Lead, supervise, coach and develop claims staff.
• Set performance targets and monitor achievement.
• Conduct performance reviews and identify training needs.
• Foster a high-performance and customer-centric culture
• Prepare management reports on claims performance, costs and trends.
• Maintain strong relationships with customers, intermediaries, branches and regulators.
• Provide insights and recommendations to improve portfolio performance
• The incumbent will be responsible for ensuring adherence to, implementation of, and adoption of Compliance, Anti-Money Laundering (AML), and Sanctions-related policies, procedures, and process requirements within Old Mutual and its subsidiaries. This includes execution of customer due diligence processes, ensuring compliance with Know-Your-Customer (KYC) standards, conducting ongoing and enhanced due diligence, and maintaining data quality. Additionally, the role involves identifying and monitoring potential AML, Sanctions, or Compliance breaches and unusual activities, and escalating these concerns to the Risk and Compliance Office for further action.

• Strategic thinking
• Computer skills
• Staff Supervision, training and performance management skills
• Leadership & People Management
• Analytical & Problem-Solving Skills
• Communication & Interpersonal Skills
• Customer Service Orientation
• Negotiation & Stakeholder Management
• Financial & Claims Management Skills
• Ability to work with minimum supervision

• Bachelor’s degree in insurance, Business Administration, Actuarial Science, Statistics, Commerce, Finance or related field.
• Professional qualification such as ACII, ANZIIF or Advanced Diploma in Insurance.