Living Benefit Claims: Claims Consultant: JG: 09 / 10

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Date: 23-Nov-2021

Location: Bellville, Western Cape, South Africa

Company: Sanlam Group

Who are we?

The Sanlam Retail Affluent business (SRA) is dedicated to empower South Africans in the middle- and upper-income segments to be financially confident, secure and prosperous. With deep client understanding and a focus on excellence in technology, client and intermediary experiences, SRA delivers financial solutions including comprehensive financial planning, life- and disability insurance, credit solutions, savings and investments, retirement and fiduciary services that can be accessed through various platforms.

Output/Core Tasks:

 

  • Assessment and independent decision making of complex living benefits e.g. severe illness, disability and sickness benefit claims.
  • Ensure that the client’s claim request is met within the boundaries of the policy contract, which includes the interpretation of contractual definitions.
  • Liaise with relevant stakeholders (e.g. Underwriters, Legal Department, Product Development, Medical Doctors, Re-insurers) to resolve complex assessments.
  • Propose improvements to the assessment process.
  • Written and verbal communication with clients, intermediaries, underwriters and doctors during the assessment process and on outcome of the claim.
  • Taking full ownership for the communication of the outcome of the claim to the client and intermediary that enables them to understand the decision and prevent complaints.
  • Complaints handling
  • Contact person to VIP intermediaries for technical enquiries and their client’s claims

Role Requirements:

 

Qualifications and experience:

 

  • Matric with Mathematics
  • Occupational Therapist qualification or any other medical equivalent qualification

 

Minimum Experience:

 

  • Experience as an Occupational Therapist or clinical role in the medical field
  • 5-7 years’ experience in the assessment of Living Benefit Claims. or Risk claims is recommended.
  • Experience in complaints handling
  • Knowledge of Risk Products and Benefits  is recommended

Competencies:

 

  • Manages complexity
  • Client focus
  • Good communication skills in English and Afrikaans (written and verbal)
  • Working independently
  • Results driven
  • Collaboration skills
  • Being resilient
  • Cultivates innovation.

Turnaround time

 

The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of managers. 

 

Closing date: 4 December 2021

Our commitment to transformation

The Sanlam Group is committed to achieving transformation and embraces diversity.  This commitment is what drives us to achieve a diverse, inclusive and equitable workplace as we believe that these are key components to ensuring a thriving and sustainable business in South Africa.  The Group's Employment Equity plan and targets will be considered as part of the selection process.