South Africa Job Openings

Sanlam
Living Benefits Claims Consultant 1
Bellville
FULL TIME
October 9, 2024
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Assessment and independent decision making of complex living benefits e.g. severe illness, disability and sickness benefit claims.
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Ensure that the client’s claim request is met within the boundaries of the policy contract, which includes the interpretation of contractual definitions.
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Liaise with relevant stakeholders (e.g. Underwriters, Legal Department, Product Development, Medical Doctors, Re-insurers) to resolve complex assessments.
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Propose improvements to the assessment process.
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Written and verbal communication with clients, intermediaries, underwriters and doctors during the assessment process and on outcome of the claim.
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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.
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Complaints handling.
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Contact person to VIP intermediaries for technical enquiries and their client’s claims.
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Experience as an Occupational Therapist or clinical role in the medical field
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3-5 years experience in the assessment of Living Benefit Claims or Risk claims or Retail claims is recommended.
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Experience in complaints handling
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Knowledge of Risk Products and Benefits is recommended
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Manages complexity
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Good communication skills in English and Afrikaans (written and verbal)
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Working independently
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