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Claims Examiner - A&H

  • Job
    Full-time
    Mid Level
  • Customer Relations
    Legal
  • Johannesburg
  • Quick Apply

AI generated summary

  • You need Matric, preferably a Short Term Insurance qualification, FAIS compliance, 3 years as a Claims Examiner, and strong skills in problem solving, negotiation, and customer focus.
  • You will manage claims efficiently, assess coverage, set reserves, ensure timely settlements, maintain excellent customer service, control expenses, and ensure compliance with claims regulations.

Requirements

  • 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

Responsibilities

  • 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.
  • 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.

FAQs

What is the main responsibility of a Claims Examiner at AIG?

The main responsibility of a Claims Examiner at AIG is to provide efficient and professional Claims service to customers through prompt and fair settlement of Claims within mandate, while contributing to business development and retention.

What qualifications are required for this position?

Required qualifications include a Matric, a preferred Short Term Insurance qualification, and being FAIS compliant.

How much experience is needed for this role?

A minimum of 3 years of experience as a Claims Examiner is required, including experience in the specific Line of Business applicable to the role.

What are the core competencies needed for this position?

Core competencies include dealing with ambiguity, customer focus, negotiating, drive for results, business acumen, problem-solving, interpretation of legal agreements, knowledge of policies for regulations, and portfolio management.

What is AIG's commitment towards diversity and inclusion?

AIG is committed to creating a culture that respects and celebrates each other’s talents, backgrounds, cultures, opinions, and goals. They actively foster inclusion through flexible work arrangements, diversity learning, cultural awareness activities, and Employee Resource Groups (ERGs).

Are there opportunities for career growth and development at AIG?

Yes, AIG invests in continuous learning and development for their employees, providing opportunities to support individual growth and career advancement.

What should candidates do if they need a reasonable accommodation during the application process?

Candidates who believe they need a reasonable accommodation should send an email to candidatecare@aig.com.

Is AIG committed to equal opportunity employment?

Yes, 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.

Does AIG prioritize previously disadvantaged candidates in their hiring process?

Yes, preference will be given to previously disadvantaged candidates in line with the company’s Employment Equity Plan, with specific preference for individuals with disabilities.

Finance
Industry
10,001+
Employees
1919
Founded Year

Mission & Purpose

American International Group, Inc. (AIG) is a leading global insurance organization. AIG member companies offer insurance solutions that help businesses and individuals in approximately 70 countries and jurisdictions protect their assets and manage risks. AIG common stock is listed on the New York Stock Exchange. AIG is the marketing name for the worldwide property-casualty and general insurance operations of American International Group, Inc. All products and services are written or provided by subsidiaries or affiliates of American International Group, Inc. Products or services may not be available in all countries and jurisdictions, and coverage is subject to underwriting requirements and actual policy language. Non-insurance products and services may be provided by independent third parties. Certain property-casualty coverages may be provided by a surplus lines insurer. Surplus lines insurers do not generally participate in state guaranty funds, and insureds are therefore not protected by such funds.

Benefits

  • Physical and Mental Health benefits

  • Market-aligned base pay

  • Equitable incentive compensation

  • Life and disability insurance options