Claims Assessor Specialist

8 hours ago

Sandton, South Africa Discovery Ltd. Full time

**Business Unit**:Discovery Life

**Function**:Forensics/Fraud/Fiduciary Services

**Date**:29 Aug 2025
- Discovery - Discovery Life
- Claims Assessor Specialist - Forensics

**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 understand and support our core purpose, and whose own values align with those of Discovery. Our fast-paced and dynamic environment enables smart, self-driven people to be their best. As global thought leaders, Discovery is passionate about innovating in order to not only achieve financial success, but to ignite positive and meaningful change within our society.

**About Discovery Life**
- Discovery Life is an ever growing fast-paced and dynamic environment that provides innovative risk assurance to individual clients. This environment thrives on customer engagement and customer experience as well as mutually beneficial relationships with our brokers and other stakeholders. It is important for our employees to provide a world class service to our internal and external clients, thereby ensuring long and sustainable relationships.

**Key Purpose**
- Responsible for assisting claims specialists, assessors as support services for claims investigations.
- More specifically assisting the assessing, legal and medical team with the investigation of claims/underwriting discrepancies, obtaining evidence in order to adjudicate death, disability and severe illness claims. Collection of claims requirements, uploading and characterising of evidence, interpreting data and researching in general.

**Areas of responsibility may include but not limited to**
- To ensure the claims department is provided with properly investigated cases that will enable assessors to assess the claim and pay valid claims
- Gathering of claims related requirements, evidence, records from various third parties.
- Support services for claims, claims escalations, reviews and Ombudsman queries to ensure high quality and proficient claims assessment
- Identify claims that pose a potential risk to the business in general
- Identify possible training opportunities/ information sharing that will assist the teams to detect high risk claims.
- Participating in real time liaison with government departments, industry forums on strategy of designing and implementation of tools/strategic initiatives to identify high risk claims
- Ad hoc covert and humit surveillance operations.
- In service training regarding modern key skills in the investigation and prevention

**Competencies**
- Action orientated
- Interpersonal savvy
- Situational adaptability

**Technical Skills and Knowledge**

**Essential**:

- Data Analysis
- Ability to communicate with the public, government officials in general and claims assessors at all levels
- Testify in court or other tribunals

**Advantageous**:

- Experience in the Investigation milieu

**Qualifications & Experience**

**Essential**:

- Matric
- PSIRA registered
- General Investigations
- At least 5 yrs experience

**Advantageous**:

- Investigation and security certification
- Criminal investigation, litigation and judicial

EMPLOYMENT EQUITY

The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.

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