Claims Consultant

1 week ago


Sandton, South Africa Moving Heads Personnel Full time

**EXEPERIENCE IN THE FINANCIAL SERVICES INDUSTRY/LIFE INSURANCE ESSENTIAL**
- Responsible to drive the formulation and implementation of the risk model and underwriting philosophy, analyse claims and other data when assessing claims.
- Providing feedback on all claims, liaising with relevant stakeholders, and utilise their skills, knowledge, and experience to make appropriate and accurate decisions on claims worked on.
- Assessment of income, disability and critical illness claims following policy terms and claims philosophy as well as facilitate case management programmes

where applicable to assist claimants in their return to work.
- Evaluate claims forms and supporting documentation in preparation of making a payment decision.
- Gathering information and various types of reports from medical practitioners.
- Compare the reports to existing claims criteria to establish if claim is payable.
- Decide on levels of provisions to be raised based on information received.
- Writing claims assessment standards/policies.
- Auditing/QA of work done by peers.
- Deliver claims payment decision.
- Determine requirments/documents required to evaluate claims.
- Liase with relevant re-insurers to determine validity of claims and get their approvals where required.
- Explain and communicate final decisions to brokers and clients.
- Create schedules for payments and obtain relevant approvals.
- Relevant tertiary qualification; a medical degree preferable
- Min 2-3 yrs' exp in life insurance assessing
- Medical background
- Exp in both **group and life individual life claims** is ess.
- Business and operational knowledge of insurance industry administrative processes.
- Good knowledge of the business administration platforms.
- Familiar with compliance processes and procedures in the insurance Industry.
- Familiar with the business products and their rules and workings.

2.11kb

Ability to commute/relocate:

- Sandton, Gauteng: Reliably commute or planning to relocate before starting work (required)


  • Claims Consultant

    2 weeks ago


    Sandton, Gauteng, South Africa Guardrisk Full time R80 000 - R250 000 per year

    IntroductionGuardrisk is the undisputed market leader in cell captive insurance and risk solutions. We are renowned for our innovative approach to cell captive structures and other alternative risk transfer solutions for our clients. Guardrisk offers clients custom designed cover and is registered in South Africa as an insurer for all statutory classes of...


  • Sandton, South Africa CFS Recruitment Full time

    Job Title: Senior Claims Consultant Reporting to: Claims Manager Seniority Level: Mid Career (Above 6 yrs exp) Type: Permanent Duties and Responsibilities:Manage and settle personal and commercial short-term insurance claimsOperate within the binder agreements and handle claims settlement mandatesLiaise with insurers, clients, and service providersEnsure...


  • Sandton, South Africa Discovery Ltd. Full time

    **Business Unit**:Vitality Life **Function**:Insurance (Short Term) **Date**:8 Aug 2025 **Discovery - Insure** **Claims Consultant - Short Term Insurance (Junior - fast track)** **About Discovery** - Discovery’s core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who...


  • Sandton, South Africa PSG Wealth Financial Planning (Pty) Ltd Full time

    **PSGs commitment to transform and embrace diversity is what drives us to achieve a diverse workplace with employment equity as a key goal to create an inclusive workforce. In achieving our employment equity goals, we give preference to applicants from designated groups, and we encourage people with disability to apply.** **Job description**: The Claims...

  • Claims Consultant

    3 days ago


    Sandton, South Africa Guardrisk Full time

    **Introduction** - Guardrisk is the undisputed market leader in cell captive insurance and risk solutions. We are renowned for our innovative approach to cell captive structures and other alternative risk transfer solutions for our clients. Guardrisk offers clients custom designed cover and is registered in South Africa as an insurer for all statutory...


  • Sandton, South Africa HR Genie Full time

    Senior Claims Technician Short-Term Insurance Location: Fourways, Gauteng Salary: R30,000 R40,000 (depending on experience)With over 30 years of excellence in the short-term insurance industry, we are a trusted brokerage delivering tailored insurance solutions that protect what matters most. As we continue to grow, were looking for a skilled Senior Claims...

  • Claims Consultant

    1 day ago


    Sandton, South Africa Discovery Ltd. Full time

    **Business Unit**:Discovery Insure **Function**:Insurance (Short Term) **Date**:15 Aug 2025 **Key Purpose** - To take full ownership of the administration of all warranty claims for Discovery Insure clients and brokers, in close collaboration with M-Sure. - The role serves as a critical link between M-Sure, the client, and the broker, ensuring a seamless...


  • Sandton, South Africa Moving Heads Personnel Full time

    **EXPERIENCE IN THE FINANCIAL SERVICES/LIFE INSURANCE INDUSTRY ESSENTIAL** Responsible to drive the formulation and implementation of the risk model and underwriting philosophy, analyse claims and other data when assessing claims. Providing feedback on all claims, liaising with relevant stakeholders, and utilise their skills, knowledge and experience to...

  • Claims Specialist

    1 day ago


    Sandton, South Africa Sanlam Full time

    **What will you do?** - We have an exciting opportunity for the Claims Specialist within SHA Risk Specialists.**What will make you successful in this role?** **Key responsibilities**: **Claims Practice Management**: - Attend and manage all aspects related to a portfolio of specialist claims such as claims registration, case management, drafting, diary,...

  • Claims Assessor

    1 week ago


    Sandton, South Africa Discovery Ltd. Full time

    **Business Unit**:Discovery Insure **Function**:Insurance (Short Term) **Date**:16 Apr 2025 **Key Purpose** - To investigate and validate motor claims to determine validity based on the Discovery Insure contract. To correctly quantify and validate losses and serve as a mediator between clients and/or brokers. Provide feedback and support to claims...