Job purpose

The Assistant Claims Manager is responsible for overseeing the efficient processing and settlement of general insurance claims while ensuring compliance with policies, procedures, and regulations. The role will also require management of claims recovery processes, vendor relationships, and the overall performance of the claims department. The position demands a combination of technical expertise in claims and reinsurance operations, leadership, and strategic thinking to drive continuous improvement in claims operations and customer satisfaction.

Key responsibilities

Claims Management & Processing:

• Oversee, coordinate, and manage the timely registration, analysis, and settlement of all claims in accordance with company policies and procedures.
• Ensure accurate and prompt appointment of loss adjusters in collaboration with the underwriting and claims team.
• Monitor and evaluate the processing of all claims, ensuring that settlement is aligned with the company’s loss ratio targets and financial goals.
• Review service provider reports and ensure they meet the agreed service levels, recommending adjustments as necessary.
• Provide guidance on claims recovery processes and ensure recoveries are made efficiently and cost-effectively.
• Maintain accurate reserves and ensure they are regularly reviewed and updated.

Reinsurance Operations:

• Collaborate with the reinsurance team to ensure that risks are adequately covered through reinsurance programs.
• Monitor and assess the impact of reinsurance on claims settlement and profitability.
• Maintain a comprehensive understanding of reinsurance arrangements, ensuring claims are processed in line with both the primary policy and reinsurance agreements.

Operational Efficiency & Strategy Implementation:

• Coordinate and streamline the processing of claims to ensure customer satisfaction and retention.
• Establish and maintain strong relationships with service providers to ensure high service quality and compliance with Service Level Agreements (SLAs).
• Review departmental processes regularly, making recommendations for improvements to enhance efficiency, reduce operational losses, and maintain profitability.
• Provide management with regular reports on claims performance, including claims statistics, reserve adequacy, and loss ratios.
• Ensure that all claims are compliant with the respective insurance policy coverage and regulatory requirements.

Team Leadership & Development:

• Supervise, mentor, and provide leadership to the claims team, ensuring that they are well-equipped to meet performance targets and departmental objectives.
• Identify training needs for the department and facilitate training to enhance staff knowledge and performance.
• Set clear departmental goals and performance indicators aligned with overall business strategy.
• Foster a positive, motivated, and cohesive team environment that supports both individual and team development.
• Conduct performance appraisals, offer feedback, and implement initiatives for continuous improvement.

Compliance & Risk Management:

• Ensure compliance with all regulatory and legal requirements related to general insurance claims.
• Collaborate with internal and external auditors to provide necessary information and ensure an efficient audit process.
• Implement the company’s risk management strategies, ensuring claims are processed with due diligence to minimize exposure to fraud and other risks.
• Ensure adherence to claims guidelines, protocols, and corporate policies to safeguard against operational risks.

Customer Service & Satisfaction:

• Ensure that all customer inquiries regarding claims are addressed promptly and efficiently, ensuring high levels of customer satisfaction.
• Assist in resolving complex or escalated customer claims and provide timely updates to clients and intermediaries.
• Measure customer satisfaction through regular feedback and implement improvements based on findings.

Reporting & Performance Monitoring:

• Prepare and present regular claims reports to management, highlighting trends, claims performance, and financial implications.
• Monitor departmental performance against established KPIs and benchmarks, including claims turnaround times (TAT), customer satisfaction index, and operational losses.
• Provide actionable insights from claims data to support decision-making and strategic planning

Key Performance Measures

• Claims Processing Efficiency: TAT for claims processing, claims recovery performance.
• Financial Goals: Achievement of set loss ratios, accuracy of reserves, and claims cost management.
• Customer Satisfaction: Customer satisfaction index, retention rates.
• Regulatory Compliance: Adherence to legal and regulatory requirements.
• Operational Performance: Claims operational losses, service provider compliance with SLAs.

Internal Relationships:

• Report directly to the Claims Manager.
• Collaborate closely with the Claims and Underwriting teams to ensure smooth processing and settlement of claims.
• Work closely with the finance, legal, and compliance departments to ensure accurate claims reporting and regulatory compliance.
• Liaise with other business departments to align on overall company strategy and objectives.

External Relationships:

• Work with external service providers, including loss adjusters, legal firms, and vendors, ensuring that SLAs are adhered to.
• Establish and maintain relationships with intermediaries and clients to ensure their satisfaction with claims services.
• Collaborate with regulatory authorities and insurance sector players to ensure compliance with industry standards and regulations.

Knowledge, experience and qualifications required

1. Bachelor’s degree in Insurance, Business Administration, or a related field.
2. Professional qualification in Insurance (ACII) is required.
3. 5-7 years of successful experience in the insurance industry, with at least 2-3 years in claims management and reinsurance operations.
4. Proven experience in leading and managing teams within a claims environment.
5. Solid understanding of general insurance claims procedures and reinsurance operations.
6. In-depth knowledge of industry regulations, claims processing systems, and claims recovery procedures.

Technical and functional competencies

1. Strong knowledge of the insurance industry claims management processes, and reinsurance structures.
2. Ability to analyze and interpret claims data to identify trends, risks, and areas for improvement.
3. Proficiency in claims management software and tools.
4. Solid understanding of reserve management and loss ratio optimization.
5. Expertise in establishing and maintaining service level agreements (SLAs) with external service providers

Core competencies

6. Decision Making & Initiative: Demonstrates ability to make quick, sound decisions under pressure with limited information, ensuring departmental objectives are met.
7. Leadership & Supervising: Ability to lead and inspire a team, promoting a positive work environment and fostering a culture of excellence and continuous improvement.
8. Strategic Thinking: Ability to formulate and implement departmental strategies aligned with the company’s overall objectives, ensuring long-term growth and success.
9. Customer Focus: A strong customer-oriented mindset, ensuring that client needs are met promptly and efficiently.
10. Communication & Negotiation: Ability to persuade, influence, and negotiate with internal and external stakeholders effectively.

• Oversee, coordinate, and manage the timely registration, analysis, and settlement of all claims in accordance with company policies and procedures.
• Ensure accurate and prompt appointment of loss adjusters in collaboration with the underwriting and claims team.
• Monitor and evaluate the processing of all claims, ensuring that settlement is aligned with the company’s loss ratio targets and financial goals.
• Review service provider reports and ensure they meet the agreed service levels, recommending adjustments as necessary.
• Provide guidance on claims recovery processes and ensure recoveries are made efficiently and cost-effectively.
• Maintain accurate reserves and ensure they are regularly reviewed and updated.
• Collaborate with the reinsurance team to ensure that risks are adequately covered through reinsurance programs.
• Monitor and assess the impact of reinsurance on claims settlement and profitability.
• Maintain a comprehensive understanding of reinsurance arrangements, ensuring claims are processed in line with both the primary policy and reinsurance agreements.
• Coordinate and streamline the processing of claims to ensure customer satisfaction and retention.
• Establish and maintain strong relationships with service providers to ensure high service quality and compliance with Service Level Agreements (SLAs).
• Review departmental processes regularly, making recommendations for improvements to enhance efficiency, reduce operational losses, and maintain profitability.
• Provide management with regular reports on claims performance, including claims statistics, reserve adequacy, and loss ratios.
• Ensure that all claims are compliant with the respective insurance policy coverage and regulatory requirements.
• Supervise, mentor, and provide leadership to the claims team, ensuring that they are well-equipped to meet performance targets and departmental objectives.
• Identify training needs for the department and facilitate training to enhance staff knowledge and performance.
• Set clear departmental goals and performance indicators aligned with overall business strategy.
• Foster a positive, motivated, and cohesive team environment that supports both individual and team development.
• Conduct performance appraisals, offer feedback, and implement initiatives for continuous improvement.
• Ensure compliance with all regulatory and legal requirements related to general insurance claims.
• Collaborate with internal and external auditors to provide necessary information and ensure an efficient audit process.
• Implement the company’s risk management strategies, ensuring claims are processed with due diligence to minimize exposure to fraud and other risks.
• Ensure adherence to claims guidelines, protocols, and corporate policies to safeguard against operational risks.
• Ensure that all customer inquiries regarding claims are addressed promptly and efficiently, ensuring high levels of customer satisfaction.
• Assist in resolving complex or escalated customer claims and provide timely updates to clients and intermediaries.
• Measure customer satisfaction through regular feedback and implement improvements based on findings.
• Prepare and present regular claims reports to management, highlighting trends, claims performance, and financial implications.
• Monitor departmental performance against established KPIs and benchmarks, including claims turnaround times (TAT), customer satisfaction index, and operational losses.
• Provide actionable insights from claims data to support decision-making and strategic planning

• Strong knowledge of the insurance industry claims management processes, and reinsurance structures.
• Ability to analyze and interpret claims data to identify trends, risks, and areas for improvement.
• Proficiency in claims management software and tools.
• Solid understanding of reserve management and loss ratio optimization.
• Expertise in establishing and maintaining service level agreements (SLAs) with external service providers
• Decision Making & Initiative: Demonstrates ability to make quick, sound decisions under pressure with limited information, ensuring departmental objectives are met.
• Leadership & Supervising: Ability to lead and inspire a team, promoting a positive work environment and fostering a culture of excellence and continuous improvement.
• Strategic Thinking: Ability to formulate and implement departmental strategies aligned with the company’s overall objectives, ensuring long-term growth and success.
• Customer Focus: A strong customer-oriented mindset, ensuring that client needs are met promptly and efficiently.
• Communication & Negotiation: Ability to persuade, influence, and negotiate with internal and external stakeholders effectively.

• Bachelor’s degree in Insurance, Business Administration, or a related field.
• Professional qualification in Insurance (ACII) is required.
• 5-7 years of successful experience in the insurance industry, with at least 2-3 years in claims management and reinsurance operations.
• Proven experience in leading and managing teams within a claims environment.
• Solid understanding of general insurance claims procedures and reinsurance operations.
• In-depth knowledge of industry regulations, claims processing systems, and claims recovery procedures.