Senior Personal Lines Underwriter & Claims Specialist

Role Purpose

To fulfil a dual underwriting and claims role within the short-term personal lines environment. The successful candidate will be responsible for assessing and pricing personal lines risks, managing underwriting decisions, processing and overseeing claims, identifying risk trends, and supporting profitable portfolio management.

Minimum Experience

• 8 to 15 years’ short-term insurance experience.
• Strong personal lines underwriting experience.
• Practical claims processing and claims management experience.
• Experience assessing risk profiles and recommending pricing, terms, excesses and exclusions.

Key Responsibilities

Underwriting & Risk Assessment

• Assess new business, renewals, amendments and policy endorsements.
• Evaluate personal lines risks including motor, household contents, buildings, all risks and personal liability.
• Review client risk profiles, claims history, location, asset exposure and other rating factors.
• Recommend appropriate premiums, excesses, exclusions, endorsements and underwriting terms.
• Handle non-standard risks and underwriting referrals.
• Identify poor risks, misrepresentation, non-disclosure and potential fraud indicators.
• Assist with underwriting guidelines, rating logic and portfolio reviews.

Claims Processing & Claims Management

• Receive, register and process personal lines claims.
• Review claim documentation and confirm completeness of submitted information.
• Assess policy cover, exclusions, excesses and policy conditions.
• Liaise with clients, brokers, assessors, repairers, investigators and insurers.
• Appoint and follow up with assessors and service providers where required.
• Process claim approvals, settlements, repudiations and claim payments in line with mandate.
• Manage claims turnaround times and ensure regular communication with stakeholders.
• Identify suspicious claims, claims leakage, fraud indicators and underwriting concerns.
• Escalate complex, high-value or disputed claims appropriately.
• Assist with claims complaints, reconsiderations and ombudsman-related matters.

Pricing & Portfolio Support

• Analyse claims experience and underwriting results.
• Recommend premium adjustments based on risk profile and loss experience.
• Monitor loss ratios and identify adverse claims trends.
• Provide feedback on portfolio profitability and underwriting performance.
• Support product, rating and pricing reviews.

Broker & Client Support

• Provide technical underwriting and claims support to brokers and clients.
• Assist with complex quotations, referrals and policy queries.
• Explain underwriting and claims decisions clearly and professionally.
• Build strong working relationships with brokers, insurers and service providers.

Compliance & Administration

• Ensure underwriting and claims decisions are properly documented.
• Maintain accurate records, notes and audit trails.
• Ensure compliance with FAIS, PPR, POPIA, insurer mandates and internal processes.
• Work within agreed authority limits and escalation procedures.

Minimum Requirements

• Matric.
• Relevant short-term insurance qualification.
• RE5 advantageous.
• FAIS compliance advantageous.
• Strong understanding of personal lines policy wordings.
• Good technical knowledge of underwriting, claims and risk pricing.
• Computer literate with strong administration and reporting ability.

Key Skills

• Personal lines underwriting.
• Claims processing and claims assessment.
• Risk-based pricing.
• Policy wording interpretation.
• Claims validation and repudiation assessment.
• Fraud and non-disclosure identification.
• Broker and client communication.
• Analytical thinking and sound judgement.

Ideal Candidate Profile

The ideal candidate is a strong technical personal lines insurance professional who can operate across both underwriting and claims. They should be able to assess whether a risk is acceptable, determine what pricing or terms should apply, process and assess claims, identify claims trends, and support management in improving underwriting profitability.

Employment Type

Full-time or consulting/fractional arrangement, depending on candidate availability and business requirements.