Living Benefits Claims Consultant
4 days ago
**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.
**What will you do?**
- 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.
**What will make you successful in this role?**
**Knowledge & Experience**:
- Experience as an Occupational Therapist or clinical role in the medical field
- 3-5 years experience in the assessment of Living Benefit Claims or Risk claims or Retail claims is recommended.
- Experience in complaints handling
- Knowledge of Risk Products and Benefits is recommended
**Competencies**:
- Manages complexity
- Good communication skills in English and Afrikaans (written and verbal)
- Working independently
**Qualification and Experience**
- Degree or Diploma with 3 to 5 years related experience.**Knowledge and Skills**
- Claims administration- Claims settlements of a complex nature- Claims approvals and rejections- Operate within claims guidelines and compliance- Coach and develop others**Personal Attributes**
- Business insight - Contributing independently- Manages complexity - Contributing independently- Plans and aligns - Contributing independently- Manages conflict - Contributing independently**Build a successful career with us**
- We’re all about building strong, lasting relationships with our employees. We know that you have hopes for your future - your career, your personal development and of achieving great things. We pride ourselves in helping our employees to realise their worth. Through its five business clusters - Sanlam Fintech, Sanlam Life and Savings, Sanlam Investment Group, Sanlam Allianz, Santam, as well as MiWay and the Group Office - the group provides many opportunities for growth and development.**Core Competencies**
- Cultivates innovation - Contributing independently- Customer focus - Contributing independently- Drives results - Contributing independently- Collaborates - Contributing independently- Being resilient - Contributing independently**Turnaround time**Closing date: 14 June 2024**
**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.
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