Senior Legal Claims Officer

About the role

The Senior Legal Claims Officer will lead the end‑to‑end management of insurance claims, ensuring compliance with legal and policy requirements while providing expert advice to customers and internal teams.

Key responsibilities

• Review claim documents and verify completeness against insurance requirements.
• Advise customers on coverage matters related to their claims.
• Respond to internal and external inquiries about benefits, claim processes, and required forms.
• Maintain accurate claim registers, track advocate appointments, and update status reports.
• Manage external advocates on the Britam panel, reviewing legal costs and ensuring SLA compliance.
• Process payments to insured parties and service providers.
• Assist with third‑party recoveries, subrogation, and reserve reviews according to guidelines.
• Prepare comprehensive file notes for judgments and out‑of‑court matters.

Required profile

• Bachelor’s degree in Law (LLB) and PDG from KSL.
• 6‑9 years of experience in insurance claims processing.
• Relevant professional certifications (CPA, AIIK, ACII) are an advantage.
• Annual CLE points required.

Required skills

• Insurance Claims Management
• Legal Claims & Litigation Management
• Insurance Law & Regulatory Compliance
• Policy Interpretation & Coverage Analysis
• Claims Liability Assessment & Reserving
• Legal Costs & Panel Advocate Management
• Claims Recoveries, Subrogation & Settlements
• Claims Reporting, Analysis & Systems Management