Life Claims Assessor

Team Claims

Working Pattern -Hybrid2days per week in the Vitality Sandton Full time.

Key skills required for this role:

• Medical & Claims Assessment Expertise
• HighLevel Communication Skills (Written & Verbal)

As aClaims Assessor Specialist you will be responsible for assessing Life Cover Terminal Illness and Critical Illness claims.

Although this role is primarily homebased there may be occasions when you are required to attend the office.

Responsibilities

• Assess the validity of submitted claims ensuring all decisions are made in accordance with industryleading UK claims practices. This includes reviewing medical and supporting evidence obtaining further information where required and drafting and issuing clear accurate decision letters and related correspondence.
• Identify potential concernssuch as fraud nondisclosure misrepresentation or preexisting conditions.
• Collaborate with strategic underwriters management reinsurers and other key stakeholdersto ensure fair timely and accurate claim outcomes.
• Provide mentoring and coaching to junior team members which may include facilitating case study sessions delivering training on specialist topics and supporting their technical development.
• Assist in complaint resolution ensuring thorough investigation and professional communication throughout the process.

Essential Skills & Experience

• Experience assessing and managing Life Cover and tiered Critical Illness claims.
• Strong understanding of the UK insurance market and regulatory environment.
• Proven experience working with reinsurers.
• Ability to present ideas confidently and deliver training to peers.
• Advanced verbal and written communication skills.
• Intermediate proficiency in Microsoft Word Excel PowerPoint and other common Office applications.