Underwriting and Claims Leader

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Underwriting and Claims Leader

The Underwriting and Claims Leader is accountable for leading and overseeing the Underwriting and Claims functions at the operational and tactical levels. This is primarily a leadership and supervisory role – approximately 80% oversight rather than hands-on case processing. This role monitors and safeguards the quality of underwriting and claims decisions made by the team, manages escalations, disputes and high-value or complex cases, and steps in only where needed to protect turnaround times and service level agreements (SLAs). The role holds the underwriting and claims team accountable to internal governance standards, and to regulatory, Guardrisk, and reinsurer requirements, while also carrying standard leadership responsibilities for people management, performance, and reporting.

Application deadline

August 14, 2026

Capital Legacy

Employment type

Permanent

Location

Johannesburg

1 position open

Roles and responsibilities

UNDERWRITING LEADERSHIP AND QUALITY OVERSIGHT

Team Oversight and Decision Quality

• Lead and oversee the underwriting team, ensuring decisions are applied consistently in line with underwriting guidelines, risk frameworks, and company policy.
• Review and quality-check underwriting decisions made by the team, with particular focus on high-value, complex, or borderline cases.
• Ensure underwriting decisions balance business growth with responsible risk management across the team's portfolio.

Escalations and Hands-on Intervention

• Act as the escalation point for complex or contentious underwriting cases requiring senior judgement.
• Personally assist with case assessment where cases are approaching or breaching SLA, to protect turnaround commitments.
• Apply exclusions, loadings, or underwriting conditions on escalated cases where required.

Risk Monitoring

• Monitor trends in underwriting outcomes and decision quality to proactively manage portfolio risk.
• Identify potential high-risk patterns and implement appropriate controls and coaching interventions.

CLAIMS LEADERSHIP AND QUALITY OVERSIGHT

Team Oversight and Decision Quality

• Lead and oversee the claims team, ensuring claims are assessed and decided in line with policy terms, claims philosophy, and regulatory requirements.
• Review and quality assure claims decisions and reserving accuracy, with particular focus on high-value, contentious, or complex claims.
• Ensure claims are handled in line with Treating Customers Fairly (TCF) principles and with appropriate empathy.

Escalations and Hands-on Intervention

• Act as the escalation point for claims disputes, complaints, and cases requiring senior judgement.
• Personally assist with claims assessment where cases are approaching or breaching SLA, to protect turnaround commitments.
• Oversee resolution of repudiations, ex-gratia considerations, and other sensitive claims decisions.

Risk Monitoring

• Monitor claims trends, including frequency, severity, and potential fraud indicators, escalating concerns as needed.
• Identify systemic issues in claims patterns and drive corrective action with the team

People Management and Team Leadership

• Manage, coach, and develop underwriting and claims team members to build capability and consistency.
• Conduct performance monitoring and reviews against set standards, providing regular feedback.
• Identify training needs and upskill team members on underwriting and claims processes, policy changes, and systems.
• Act as the first point of escalation for team-related queries and provide stand-in cover to maintain business continuity during staff absence.
• Foster a high-performance, compliant, and service-focused team culture across both functions.

Governance, Compliance and Risk Control

• Ensure underwriting and claims activities comply with internal policy, regulatory requirements, Guardrisk requirements, and reinsurer treaty conditions.
• Monitor adherence to underwriting and claims risk guidelines, authority mandates, and decision thresholds.
• Maintain accurate, audit-ready documentation supporting underwriting and claims decisions.
• Identify compliance risks across both functions and drive corrective action.
• Support internal and external audit processes, including regulatory and reinsurer reviews.

Reporting and Business Analytics

• Prepare and maintain monthly underwriting and claims production and performance reports for senior leadership.
• Monitor underwriting and claims KPIs, loss ratios, and operational indicators.
• Analyse underwriting and claims data to identify performance trends, emerging risks, and improvement opportunities.
• Maintain underwriting and claims dashboards and ensure data integrity within reporting systems.
• Provide ad-hoc reporting and analytical insights to management as required.

Operational Process Optimisation

• Identify inefficiencies or bottlenecks within underwriting and claims workflows.
• Recommend and implement improvements to enhance productivity, quality, and turnaround times.
• Develop and maintain standard operating procedures, ensuring consistent application across both teams.
• Coordinate with internal teams to ensure underwriting and claims processes align with wider business operations.

Stakeholder Coordination and Relationship Management

• Engage with brokers, broker consultants, reinsurers, and Guardrisk on underwriting and claims matters.
• Provide clear explanations for underwriting and claims decisions to stakeholders where required.
• Collaborate across underwriting and claims to ensure consistent, aligned risk and claims decision-making.
• Represent the underwriting and claims functions in relevant internal forums and cross-functional initiatives.

Strategic Planning and Business Contribution

• Participate in business planning initiatives relating to underwriting and claims performance.
• Contribute insights on risk appetite, product design, and reinsurance arrangements from an underwriting and claims perspective.
• Balance growth initiatives with prudent risk and claims management principles.
• Drive continuous improvement initiatives to strengthen underwriting and claims practices.

What we look for in our ideal candidate

Education And Experience Requirements

• Matric (Grade 12) – minimum requirement.
• Degree in Finance, Insurance, Law, Business, or Risk Management — preferred.
• Professional underwriting and/or Claims qualification/s — preferred.
• Proven experience leading or supervising underwriting and/or Claims teams.
• Solid technical background in Underwriting and Claims assessment.
• Experience of managing escalations, disputes, and high-value or complex cases.
• Experience of working within regulatory, Guardrisk, and reinsurance frameworks.
• Exposure to strategic planning, reporting, and people management.
• Experience of working with brokers and insurance stakeholders.

Key skills

• Underwriting and claims technical knowledge.
• Risk analysis and quality assurance.
• Regulatory, Guardrisk, and reinsurance knowledge.
• Data interpretation and reporting.
• Strong leadership and people management abilities.
• Sound and decisive judgement under pressure.
• Structured and analytical thinking.
• Ability to manage escalations, disputes, and difficult conversations calmly.
• Coaching and team development orientation.
• Ability to balance risk, growth, and client service objectives.

Personal attributes

• Natural leader who leads by example.
• Analytical and detail-oriented, while comfortable delegating operational detail.
• Decisive and able to remain objective when adjudicating escalated decisions.
• Resilient under pressure, particularly during peak or high-escalation periods.
• Strong listening and communication skills.
• Continuous learner and problem solver.

Remuneration

Market related

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