Short Term Buildings/Structural Claims Junior Assessor - Pretoria East

Role Purpose

Our client is seeking a detail-oriented and customer-focused Short Term Claims Junior Assessor to support the accurate, fair, and timely assessment of homeowners' insurance claims. This role focuses exclusively on buildings and structural (non-motor) claims, ensuring that claims are assessed in accordance with policy terms, regulatory requirements, and internal claims standards.
Working closely with the Short Term Claims Team, the successful candidate will assist in evaluating claims, validating policy cover, gathering supporting information, and progressing claims efficiently while delivering exceptional customer service. This is an excellent opportunity for an individual looking to develop a career in short-term insurance claims assessment.

Key Responsibilities

Claims Assessment & Processing

• Assess allocated homeowners' insurance claims in accordance with policy terms, conditions, exclusions, and limits.
• Gather and verify all supporting documentation from policyholders, contractors, service providers, and internal stakeholders.
• Assess claims for indemnity, ensuring accurate application of excesses, policy conditions, and settlement calculations.
• Escalate complex, disputed, or high-value claims to senior assessors with clear supporting documentation.
• Process approved claims within delegated authority while maintaining compliance with internal controls.

Buildings & Structural Claims Support

• Conduct desktop assessments using photographs, contractor reports, repair quotations, and supporting documentation.
• Assist with site inspections under the guidance of senior assessors where required.
• Evaluate repair quotations and scope-of-work documents, identifying discrepancies or areas requiring further investigation.
• Assess common homeowners' claims including:
  • Storm damage
  • Fire damage
  • Burst pipes
  • Geyser failures
  • Power surge claims
  • Subsidence and structural damage
• Apply building and structural knowledge when evaluating claims and determining appropriate outcomes.

Fraud Identification & Risk Management

• Identify potential fraud indicators during the assessment process.
• Escalate suspicious claims promptly in accordance with company procedures.
• Verify supporting documentation and investigate inconsistencies where necessary.
• Promote fraud awareness through accurate claim validation and reporting.

Regulatory Compliance

• Ensure all claims comply with applicable Short-Term Policyholder Protection Rules (PPRs).
• Apply Treating Customers Fairly (TCF) principles throughout the claims process.
• Maintain complete, accurate, and auditable claim records.
• Ensure assessment decisions comply with company policies and regulatory requirements.

Customer & Stakeholder Engagement

• Provide professional and empathetic service to policyholders throughout the claims process.
• Keep customers informed of claim progress and manage expectations effectively.
• Liaise with brokers, contractors, suppliers, and internal Claims Consultants to facilitate claim resolution.
• Escalate complaints or customer concerns in line with internal procedures.

Continuous Learning & Development

 

• Participate in coaching, mentorship, and formal training programmes.
• Keep up to date with policy wording changes, regulatory developments, and claims best practices.
• Participate in quality reviews, calibration sessions, and team meetings.
• Contribute to continuous improvement initiatives within the claims department.

Role Requirements

Qualifications

• Grade 12 (Matric) (Essential).
• RE5 qualification completed or in progress (Advantageous).
• National Diploma or Bachelor's Degree in Insurance, Business Administration, Built Environment, or a related field (Advantageous).
• Short-Term Insurance qualification through the Insurance Institute of South Africa (IISA) or equivalent (Advantageous).

Experience

• Minimum 1–2 years' experience within a short-term insurance claims environment.
• Proven experience in buildings, structural, or non-motor homeowners' claims is essential.
• Experience assessing homeowners' insurance claims, including policy interpretation and claim validation.
• Exposure to claims administration or claims management systems.
• Experience reviewing contractor quotations, repair estimates, and policy documentation will be advantageous.

Knowledge & Skills

• Good understanding of homeowners' insurance policies, cover, exclusions, and policy conditions.
• Working knowledge of residential building construction, including roofing, plumbing, walls, foundations, and structural components.
• Ability to interpret contractor quotations, repair scopes, and supporting documentation.
• Understanding of Short-Term Policyholder Protection Rules (PPRs), Treating Customers Fairly (TCF), and basic fraud indicators.
• Good numerical ability with accurate settlement calculations.
• Computer literacy with proficiency in Microsoft Word, Excel, Outlook, and claims management systems.
• Excellent communication, organisational, and customer service skills.
• Strong analytical ability with excellent attention to detail.
• Ability to work under pressure while managing multiple claims effectively.

Should you not receive a response within 10 working days, please consider your application unsuccessful.