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Head of Claims - Durban

The Unlimited Group Ltd

Company: The Unlimited

Position: Head of Claims & Product Fulfilment

Department: Claims and Product Fulfilment

Location: Pinetown, Durban


Accountable to: Group CFO

Direct reports: 2-3

Purpose of the Role

A great opportunity for a strong leader with financial and/or commercial acumen to plan, lead, organise, control and manage the Claims & Product Fulfilment areas of the business.

The Head of Claims will be a leader using their claims expertise and client relationship skills to enhance the client experience, resolve claim escalation issues for our clients and business partners and manage relationship with underwriters.

In addition to overseeing both the product fulfilment and claims of The Unlimited, the Head of Claims will be an integral member of the Customer Business Leadership Team providing claims intelligence and oversight.

Key Responsibilities

  • Direct responsibility and oversight of the Claims teams, accountable for all Claims KPIs and metrics.
  • Working closely with the Commercial Executive and Group CFO to achieve the

overall business goals;

  • Ensure customer proposition fulfilment and regulatory requirements are met
  • Foster and maintain a reputation of TU Claims excellence.
  • Develop, position, and deliver superior claims services and capabilities
  • Contract administration and management
  • Training and development of team members
  • Act as the point of contact with the client during the claim issue escalation and resolution process.
  • Handling queries from clients and colleagues and resolving problems
  • Engage with Underwriters, Business Partners and Finance on relevant projects, monthly, quarterly and annual reporting.
  • Utilize claims intelligence and data analytics; develop relevant insights for mitigation of fraud and benefit abuse.
  • Ensure the appropriateness of claims payments
  • Interlock with Legal and compliance to identify trends in the legal, regulatory and claims environment.
  • Provide strategic support and value by managing the cost of claims through improved claims handling processes, data usage and technology solutions.
  • Represent the claims capability of the organization to regulators, underwriters and business partners.
  • Develop tools and strategies, in collaboration with HR, to attract and retain top talent and develop high performing teams.
  • Driving a culture that promotes collaboration, diversity and inclusion.
  • Strong knowledge of insurance claims management and process
  • Proven experience in building and leading high performing teams
  • Monitoring and manging loss ratio performance through developing and implementing leakage control initiatives.
  • Reviews performance achievements of team formally bi-annually.
  • Drives own and team development for current position and career plan.
  • Owning the relationships with the strategic partners that provide product benefits to The Unlimited.

Knowledge and Experience:

  • Tertiary qualification (3yr Degree) or equivalent business operations


  • 10 years working operational experience in supporting product fulfilment

and/or claims and related services.

  • Experience in analysing operational issues (Problem Solving).
  • Experience in managing external partners.
  • 5-10 years' management experience
  • 3-5 years' investigative experience
  • 3-5 years' call centre experience

Skill Competencies:

  • Relationship Management
  • Strategic Planning
  • Results-driven
  • Professional and strong Negotiation Skills
  • Experience is extracting and interpreting customer data related to product

utilisation to identify problems and operational support enhancements.

  • Ability to develop and implement tactical plans through the interpretation

of the operational data.

  • Excellent interpersonal skills as well as verbal and written communication skills.
  • Stakeholder management skills.
  • Ability to analyse product operational and performance data.
  • Ability to deliver against product briefs and business requirement documents.
  • Leadership Skills with a desire to excel and lead a team
  • Presentation skills.
  • The ability to work in a team as well as individually
  • Good attention to detail and accuracy
  • Methodical approach with a high level of skill in organising and prioritising
  • IT literate, strong Excel and system skills
  • Must be highly proficient in dealing with clients at all levels.
  • Excellent administrative skills
  • Self-disciplined and ability to work under pressure and to deadlines
  • Self-motivated.
  • Analytical with good excel and MIS experience
  • Problem solving skills and solution oriented
  • Flexibility, ability to multi-task and attention to detail
  • Strong understanding of Insurance products and claims processes.
  • Strong understanding of financial business results as relate to insurance.
  • Numeracy and data analysis in relation to portfolio performance and Claims
  • Ability to draft professional, articulate, well-structured and accurate reports.
  • Business acumen.

Personal Characteristics:

  • Self-Generator
  • Passionate
  • Driven
  • Analytical
  • Accurate
  • Working in Action.
  • Operational
  • Team player.
  • Ownership.
  • Accountability.
  • Solution Oriented.

If you are looking to make a deep impact by rolling up your sleeves in a fast-paced entrepreneurial environment, this is an exciting opportunity for you! If you think you have what it takes, apply. Should you not hear from us within 2 weeks, please consider your application unsuccessful.

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