Let's Write Africa's Story Together!

Old Mutual is a firm believer in the African opportunity and our diverse talent reflects this.

Job Description

Critical objectives and responsibilities

Plan or, implement and manage the claims strategic plan within designated area.

Contain claims spend.

Claims settlement in accordance with SLAs. 

Manage effective customer service and relations to drive service excellence

Service delivery to ensure customer satisfaction

Maintain people practices in line with organisational guidelines, policies, culture and values

Manage effective cost control in the core processes and ensure adherence to financial and corporate policies and procedures

Comply with governance controls to reduce risks.

Experience, knowledge & skills required

Matric

COP or higher insurance qualification or studying towards same

3 years relevant claims experience

People management experience an advantage.

The Recruitment process:

TA Interview: This will be a discussion with a member of the TA Team to give you an understanding of our business, our culture & values and more context on the role. It will also allow up the opportunity to get to know you a little better, and ensure OMI can meet your needs

Panel Interview: This will be with 2 members of the senior leadership of the data team and 1 member of the HC leadership team

Technical & Psychometric Assessments: These will depend on the role and will sometimes happen concurrently with MIE & Internal Verification

Final Feedback

All About OMI:

https://www.oldmutual.co.za/about/old-mutual-insure/

https://www.linkedin.com/posts/old-mutual-insure_i-work-at-old-mutual-insure-of-course-activity-7161674472469524483-w0j6?utm_source=share&utm_medium=member_desktop

Ensures that general insurance claims are handled expeditiously and in a professional manner thereby meeting the customer expectations. Manages the claims function with a team of claims assessors and negotiators. Develops the claims policy, procedures, and practices. Evaluates risks with claims, coverage complexity, and those in excess of field approval limits. Provides counsel regarding claims evaluation and coverage.

ResponsibilitiesInsurance Claims Evaluation

Investigate the circumstances of complex, high-value claims and the nature and extent of clients' losses. Review and evaluate information gathered using own expertise, and examine additional evidence provided by specialist investigators or subject-matter experts to determine the extent of liability. Negotiate settlement of insured losses in line with delegated authority.

Insurance Claims Administration

Review and analyze very complex, high-value insurance claims in line with the organization's claims policies, procedures, and customer service standards. Initiate specialist investigations and engage loss adjusters and/or subject-matter experts where appropriate. Authorize claims within delegated authority and refer complex or unresolved issues to line manager.

Fraud/Financial Crime Management

Develop and deliver specialized fraud prevention and monitoring activities for an area of operations, in line with the organization's fraud management policies and procedures, to enable the prevention of fraud and enable the initiation of loss mitigations and fraud investigations.

Fraud/Financial Crime Investigation

Investigate cases of suspected fraud or financial crime. Identify lines of inquiry, and gather and retain information and physical or electronic evidence to support criminal investigation and/or legal action, engaging specialist investigators or subject-matter experts where necessary. Review the evidence gathered and recommend appropriate action to the organization.

Fraud/Financial Crime-Management Systems Development

Research and identify fraud trends and emerging risks, contribute to the drafting of fraud prevention policies and procedures, and identify opportunities for new and/or improved anti-fraud systems functionalities to support the development of fraud/financial crime prevention strategies, policies, procedures, and monitoring systems.

Leadership and Direction

Communicate the local action plan; explain how this relates to the function's strategy and action plan and to the broader organization's mission and vision; motivate people to achieve local business goals.

Work Scheduling and Allocation

Develop short- or medium-term work schedules in order to achieve planned commitments. Approve overtime or use additional resources as needed.

Financial Policies, Guidelines, and Protocols

Develop and deliver financial guidelines and protocols to ensure the company complies with regulations and good financial practice.

Performance Management

Develop and propose own performance objectives; take appropriate actions to ensure achievement of agreed objectives, using the organization's performance management systems to improve personal performance. Or manage and report on team performance; set appropriate performance objectives for direct reports or project/account team members and hold people accountable for achieving them, taking appropriate corrective action where necessary to ensure the achievement of team/personal objectives.

Solutions Analysis

Analyze specific problems and issues to find the best solutions. Solutions could be technical or professional in nature.

Regulatory and Compliance Management

Investigate all kinds of incidents and reports and provide expert advice to more senior colleagues. Minimize risk exposures and ensure adherence with regulatory standards by working with all internal functions to make sure compliance programs are properly implemented.

Organizational Capability Building

Use the organization's formal development framework to identify the team's individual development needs. Plan and implement actions to build their capabilities. Provide training or coaching to others throughout the organization in own area of expertise to enable others to improve performance and fulfill personal potential.

Skills

Action Planning, Claims Management, Data Compilation, Data Controls, Executing Plans, Financial Auditing, Insurance Claims Investigations, Oral Communications, Policies & Procedures, Typology

Competencies

Business Insight

Collaborates

Communicates Effectively

Decision Quality

Directs Work

Ensures Accountability

Financial Acumen

Instills Trust

Education

NQF Level 7 - Degree, Advance Diploma or Postgraduate Certificate or equivalent

Closing Date

16 January 2025 , 23:59

The appointment will be made from the designated group in line with the Employment Equity Plan of Old Mutual South Africa and the specific business unit in question.

Old Mutual Limited is pro-vaccination and encourages its workforce to be fully vaccinated against Covid-19.

All prospective employees are required to disclose their vaccination status as part of the recruitment process.

Please refer to the Old Mutual’s Covid-19 vaccination policy for further detail. Kindly note that Old Mutual reserves the right to reinstate the requirement to vaccinate at any point if it is of the view that it is imperative to do so.

The Old Mutual Story!