Senior Remote Claims Adjuster - Complex Claims

Discover senior claims adjuster opportunities focusing on complex claims. This role demands a keen eye for detail, strong analytical skills, and a thorough understanding of insurance policies and regulations. Professionals in this field are responsible for investigating, evaluating, and negotiating settlements for intricate insurance claims, ensuring fair and timely resolution. Leverage your expertise in risk assessment and claims management to excel in this challenging and rewarding career path. Explore available positions and advance your career in the insurance sector.

Senior claims adjusters managing complex claims in South Africa can expect to earn between R400,000 and R750,000 annually. This range can fluctuate based on experience, specific industry, and the complexity of claims handled. Additional benefits and performance bonuses may also be part of the compensation package.

Key responsibilities include thoroughly investigating and assessing complex insurance claims, determining coverage, negotiating settlements, and managing litigation when necessary. This role requires strong communication skills to interact with policyholders, legal counsel, and other stakeholders. Accurate documentation and adherence to regulatory requirements are paramount.

A relevant degree in business, finance, or a related field is often preferred. Professional certifications in claims adjusting and extensive experience in handling various types of complex claims are typically essential. Strong analytical, problem‑solving, and negotiation skills are also critical.

Leading insurance providers such as Old Mutual Insure, Santam, and Hollard Insurance frequently seek experienced senior claims adjusters. These companies offer diverse portfolios and opportunities to manage a wide array of complex claims.

Exceptional analytical and critical thinking skills are vital for evaluating complex claim details. Strong negotiation and communication abilities are necessary for reaching fair settlements. Proficiency in claims management software and a deep understanding of insurance law are also crucial.

About the Role

Our client, a distinguished national insurance firm known for its exceptional service in handling complex claims, is seeking a highly skilled and independent Loss Adjuster to join their fully remote team. This is an excellent opportunity for an experienced professional to manage a diverse portfolio of intricate claims from their home office, providing expert assessment and reporting. You will be responsible for investigating the cause and extent of loss or damage, determining policy coverage, negotiating settlements, and ensuring efficient resolution. As a remote‑first role, you will enjoy the ultimate flexibility while playing a critical role in delivering timely and accurate claims services across the country. This position requires a proactive and diligent individual with a strong understanding of various insurance lines.

Key Responsibilities

• Investigate, assess, and report on complex insurance claims, including property, liability, and business interruption, determining coverage and quantum.
• Conduct detailed site inspections (virtually or in‑person as required by the claim) and gather all necessary evidence, documentation, and statements.
• Analyze policy wordings to confirm coverage and identify any exclusions or limitations.
• Quantify damages and liabilities, preparing comprehensive reports for the insurer.
• Negotiate settlements with policyholders, claimants, and their representatives in a fair and timely manner.
• Maintain accurate and organized claim files, ensuring all activities are meticulously documented and in compliance with regulatory standards.
• Provide expert advice and guidance to insurers on claims matters.
• Manage a caseload effectively, prioritizing tasks and meeting deadlines in a remote work environment.
• Stay informed about industry best practices, legal requirements, and emerging trends in loss adjusting.
• Liaise professionally with all relevant parties, including clients, legal counsel, and expert witnesses.
• Utilize digital tools and platforms to manage claims efficiently from a remote location.

Requirements

• A minimum of 6 years of experience as a Loss Adjuster, with demonstrated expertise in handling complex claims across multiple lines of business.
• Strong understanding of insurance principles, policy wordings, and claims investigation techniques.
• Excellent analytical, problem‑solving, and decision‑making skills.
• Exceptional negotiation, communication, and interpersonal abilities, crucial for remote client interactions.
• Proficiency in using digital claims management software and standard office applications.
• Relevant professional qualifications (e.g., ACII, CIP) are highly desirable.
• Ability to work autonomously, manage time effectively, and maintain high productivity in a fully remote setting.
• Must possess a reliable internet connection and a suitable home office environment.
• Demonstrated commitment to ethical conduct and professional standards.
• Willingness to undertake occasional travel for site inspections if absolutely necessary.

Benefits

• Competitive remuneration package, commensurate with experience.
• Potential for performance‑based bonuses.
• Flexible work hours and the complete autonomy of a remote role.
• Opportunities for continuous professional development and specialized training.
• Be part of a well‑respected insurance firm known for its handling of challenging claims.
• Direct contribution to risk assessment and resolution for a national client base.
• Work from anywhere within South Africa, provided a stable internet connection is maintained.

Locations

Cape Town – R400000 - R750000 per year

Tembisa – R400000 - R750000 per year

Midrand – R400000 - R750000 per year

Pietermaritzburg – R400000 - R750000 per year

Soweto – R400000 - R750000 per year