Claims Manager-JG7-JHB

Role Purpose

Kandua is seeking an experienced Non-motor Claims Manager to provide operational and technical leadership to its growing non-motor claims function.

The Claims Manager will be responsible for guiding the claims team, maintaining consistent claims handling standards and ensuring that claims are delivered accurately, efficiently and in accordance with insurer mandates, service-level agreements and customer expectations.

This is a hands-on leadership role requiring substantial short-term insurance claims experience and demonstrable technical competence in plumbing, geyser, water-related, resultant damage and building claims. The successful candidate must be able to assess complex operational and technical claims matters, guide claim decisions, improve team performance and introduce the controls required to support increasing claims volumes.

The role operates at the intersection of claims operations, product, technology and Kandua's national network of service providers.

The Claims Manager will work closely with the Head of Operations, Claims Product Manager, operational teams, insurer stakeholders and Kandua Pros to ensure that the end-to-end claims process delivers appropriate indemnification, strong customer outcomes and sustainable commercial performance.

Key Responsibilities

1. Claims leadership and technical oversight

• Provide day-to-day leadership and technical guidance to the claims operations team.

• Oversee the appropriate validation, assessment, adjustment, quantification and resolution of non-motor claims.

• Guide the team on policy interpretation, indemnity, scope, settlement options and claims-handling decisions.

• Review complex, high-value, disputed or escalated claims and provide clear direction on the appropriate course of action.

• Ensure claims decisions are consistent with applicable insurer mandates, policies, procedures, regulatory requirements and delegated authorities.

• Maintain appropriate technical standards across simple plumbing, resultant damage and additional claims categories introduced by Kandua.

• Identify trends that could indicate leakage, fraud, over-servicing, under-scoping, poor workmanship or inconsistent decision-making.

• Act as the primary operational escalation point for difficult claims and technical claims queries.

2. Claims operations management

• Manage the end-to-end operational performance of the claims team.

• Ensure claims are progressed within agreed turnaround times and service-level agreements.

• Monitor workloads, team capacity, case allocation, ageing claims, backlogs and outstanding actions.

• Ensure operational issues are identified, analysed and resolved quickly.

• Introduce appropriate operating routines, controls, quality checks and escalation processes where these do not currently exist.

• Maintain visibility over claims from assignment through assessment, repair, documentation, invoicing and closure.

• Coordinate effectively with Operations, Finance, Product and the Pro network to reduce unnecessary rework and delays.

• Ensure that claims records, photographs, reports, quotations, invoices and supporting documentation are complete and accurate.

• Support business continuity and claims response during periods of increased demand or catastrophe events.

3. People leadership and performance management

• Lead, coach, support and develop the claims team.

• Establish clear responsibilities, performance expectations and service standards.

• Conduct regular one-on-ones, performance reviews, case reviews and coaching sessions.

• Ensure team members understand the technical, operational and customer-service requirements of their roles.

• Address underperformance, conduct and capability gaps promptly and fairly.

• Recognise and develop high-performing team members.

• Identify training requirements and implement structured technical and operational development plans.

• Build claims technical capability across the team.

• Build a disciplined, accountable and customer-focused claims culture.

• Support recruitment, onboarding and succession planning within the claims function.

4. Customer and stakeholder management

• Ensure customers receive professional, empathetic and timely communication throughout the lifecycle of a claim.

• Oversee the resolution of complaints and escalations, ensuring that matters are resolved fairly and promptly.

• Build strong working relationships with insurer claims teams, assessors, service providers, internal stakeholders and other claims partners.

• Participate in insurer governance meetings and operational reviews when required.

• Present claims performance, risks, service issues and corrective actions clearly to internal and external stakeholders.

• Ensure that stakeholder commitments are tracked and delivered.

• Protect Kandua's reputation by maintaining high standards of service, communication and claims decision-making.

5. Pro and service-provider performance

• Work with the Pro and Operations teams to ensure that claims are allocated to appropriately vetted, trained and capable service providers.

• Monitor Pro performance across workmanship, customer communication, turnaround times, documentation, quotation compliance, cancellations and escalations.

• Identify poor-performing service providers and recommend coaching, corrective action, suspension or removal where necessary.

• Support the prioritisation and increased allocation of work to consistently high-performing Pros.

• Ensure technical and claims-related training requirements are clearly communicated to the Pro network.

• Assist in resolving disputes involving scope, workmanship, pricing, documentation or payment.

• Support the development of consistent claims delivery standards across Kandua's national supplier network.

6. Reporting, controls and governance

• Produce accurate and meaningful claims management reports.

• Monitor key operational, customer, financial and quality indicators.

• Identify trends, root causes, risks and opportunities from claims data.

• Establish and maintain appropriate claims controls, audit trails and quality-assurance processes.

• Ensure adherence to insurer mandates, delegated authorities, service-level agreements and Kandua procedures.

• Track corrective actions arising from audits, complaints, governance reviews and operational incidents.

• Ensure that claims leakage, recoveries, duplicated costs, inappropriate settlements and avoidable rework are identified and addressed.

• Support accurate financial reconciliation between claims operations, Pros, insurers and Finance.

• Escalate material risks, control failures and service concerns to the Head of Operations and Claims Product Manager.

7. Process, product and technology improvement

• Work closely with the Claims Product Manager to translate operational requirements into product and system improvements.

• Identify manual processes, bottlenecks and control weaknesses that can be addressed through automation.

• Participate in the design, testing and implementation of claims workflows, dashboards, decision tools and system enhancements.

• Ensure that operational teams adopt and correctly use new processes and technology.

• Provide structured feedback on user experience, workflow performance and claims data quality.

• Support Kandua's objective of increasing the proportion of claims processed through standardised and automated workflows.

• Help establish scalable claims processes that can support new insurers, claim types, geographic regions and commercial partnerships.

• Promote the responsible use of data, analytics and AI to improve efficiency, quality and decision-making.

Qualifications

• Grade 12 or equivalent.

• A recognised short-term insurance or claims qualification.

• Strong working knowledge of South African non-motor insurance claims.

• Relevant regulatory and industry requirements applicable to claims handling.

• Experience in plumbin