Job Purpose:
Review, vet and endorse decisions on all litigation claim types handled in the Legal area to control associated claims cost efficiently and risk controls associated with recoveries and liabilities.
Responsibilities:
Operational Compliance:
Identify, within the team, instances of non-compliance with the organization's policies and procedures and/or relevant regulatory codes and codes of conduct, reporting these and escalating issues as appropriate.Check claims put forward for decision or amendments to original decision as well as all other supporting decisions taken throughout the claims process by adherence against the required standard.Identify trends of non-adherence to specific rules and guidelines.Escalate disputed recommendations to business managers in the relevant operational area for dispute resolution purposes.Uphold agreed service level agreements (set turnaround times) to ensure customer satisfaction and retention.Data Collection, Analysis, Insights and ReportingData Collection, Analysis, Insights and Reporting:
Conduct research using primary data sources and select information needed for the analysis of key themes and trends.Report direct findings to the Litigation & Liabilities Manager.Evaluate the effectiveness of rules, guidelines and processes application.Keep record, measure and track performance agreed standards to inform decision making in the relevant area of responsibility.Request and ensure that any additional information is received to enable the validation on claims received from the consultants in the respective teams.Improvement / Innovation:
Identify shortcomings in existing processes, systems and procedures, and use established change management programs to address them.Make recommendations for implementation on continuous improvement opportunities pertaining to rules, guidelines and processes.Recommendations:
Provide information and clarification on existing procedures, processes and precedents.Provide final sign off and endorsement of decisions put forward.Provide detailed input to line managers to enable coaching initiatives.Stakeholder Engagement (Internal & External):
Assist with stakeholder engagement by arranging actions, meetings, events, and supporting materials to promote stakeholder understanding and commitment.Provide support and assistance to legal consultants on complicated, high value or unusual claims.Effectively build, maintain and manage relationships with service providers, suppliers and colleagues.Client & Customer Management (Internal & External)
Help manage clients by carrying out standard activities and providing support to others.Manage a portfolio, engage with legal consultants regarding claims decisions.Review old and complex claims.Finalize claims and communicate the outcome with the customer.Personal Capability Building:
Develop own capabilities by participating in assessment and development planning activities as well as formal and informal training and coaching; gain or maintain external professional accreditation where relevant to improve performance and fulfil personal potential. Maintain an in-depth understanding of technology, external regulation, and industry best practices through ongoing education, attending conferences, and reading specialist media.Ensure continuous researching with options to sign on to professional boards (De Rebus e.g., sign up to SAIA).Technical Competencies:
Policy, procedures and Regulation:
Use comprehensive knowledge and skills and provide guidance and training to others on how to develop, monitor, interpret and understand policies, procedures and regulations, while making sure they match organizational strategies and objectives.Short term insurance knowledge; Claims processes and procedures; Short Term Insurance Act; Subrogation; Civil Law; Contractual law; Recovery & Liability procedures.Assessment:
Work independently and provide technical guidance when required to analyze data from multiple sources to draw appropriate conclusions and make suitable recommendations.Planning and Organizing:
Work independently and provide technical guidance when required to plan, organize, prioritize and oversee activities to efficiently meet business objectives.Action Planning:
Use comprehensive knowledge and skills and provide guidance and training to others on how to develop appropriate plans or perform necessary actions based on recommendations and requirements.Compliance:
Use comprehensive knowledge and skills to and guide and train others on how to achieve full compliance with applicable rules and regulations in management and/or operations.Computer skills:
Support business processes by understanding and effective use of standard office equipment and standard software packages, and provide technical guidance as needed.Microsoft Office Suite; Investigative Systems; Company systems.Data Collection and analysis:
Work independently and provide technical guidance when required to analyse data trends for use in reports to help guide decision making.Risk Management:
Identify, assess, prioritize and manage risks in a production process independently and provide technical guidance when required.Verbal Communication:
Use clear and effective verbal communication skills and provide technical guidance when required to express ideas, request actions and formulate plans or policies.Commercial Acumen:
Apply understanding of the business environment and cost involved in processes for decision making independently and provide technical guidance when required.Customer-Focused Approach:
Work independently and provide technical guidance when required on how to communicate with the customer regarding the process as well as the outcome of the decisions made. Manage the customer's expectation regarding the decisions taken.Collaborates with customers; Keeps customer at centre of interation; Uses common terminology.Decision Making:
Apply concepts of knowledge / skill independently regarding decisions being made within mandate and provide technical guidance when required.Education:
General Education:
Grade 12/ SAQA Accredited Equivalent (Essential).Degree in Law – BA Law. BCom Law, LLB (Essential).FAIS Regulatory Qualification (Advantageous).RE 5 (Advantageous).RE 1 (Advantageous).Relevant 3-year Business or insurance industry related degree / diploma in management (Advantageous).Experience:
General Experience:
3 or more years experience post articles within a law firm or at least 4 to 6 years in a decision-making position within the legal industry (Essential).Experience in the Financial/ Insurance Industry (Advantageous) 2-3 years Recovery and Liabilities experience in Financial Services Industry (Essential). 1-2 years experience in public liability claims (Essential).Outsourcing experience (Advantageous).Managerial Experience:
2 or more years experience coaching and supervising more junior colleagues (Essential).#J-18808-Ljbffr
