Life Cover Claims Assessor
Date: 18 Oct 2024
Location: Stellenbosch, Western Cape, ZA
Company: Capitec Bank Ltd
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We're on the lookout for energetic, self-motivated individuals who share our passion for service in the banking industry. To be part of the journey, follow the steps below:
1. To see what life at Capitec is all about and complete a short assessment, please click here!
2. Once you have completed the above finalize your application by clicking apply below
Purpose Statement
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To improve claims operational excellence, increase customer satisfaction, minimize losses for Capitec Insurance through accurate and holistic assessment of Life Cover claims, in accordance with terms and conditions of the policy, S.A legislative frameworks and goals, objectives, processes and standards sets by Capitec Life
Experience
MINIMUM:
- Minimum of 3 years' experience in assessing life insurance death claims, preferably within the context of fully underwritten products
IDEAL:
- Practical experience in life insurance underwriting, claims assessment, or related field.
- Occupational certificate of course on long-term life Insurance Claims Assessor
Qualifications (Minimum)
- Grade 12 National Certificate / Vocational
Qualifications (Ideal or Preferred)
- A relevant tertiary qualification in Healthcare or Science
Knowledge
MINIMUM:
- Understanding of the long-term insurance industry and claims handling processes and
- Deep understanding of fully underwritten life insurance policies, including underwriting criteria, exclusions and conditions
- Strong understanding of medical terminology, diagnoses, treatments, and causes of death in the context of life insurance claims.
- Knowlege of relevant legal framework relating to funeral and life insurance claims
IDEAL:
- Proven experience in life insurance underwriting, claims assessment, or related field
- Occupational certificate or course on long-term life Insurance Claims Assessor
What you will be required to do
- Support Life Cover Claims Process Set-up
- Work with the different stakeholders to develop and enhance the life cover claims assessment process.
- Engage with industry experts like reinsurers to develop a robust investigation and referral process for life cover claims.
- Life Cover Claims Assessment
- Verify documents submitted for life cover claims to ensure they are complete and legally binding
- Assess the validity of life cover claims accurately and holistically within agreed turnaround times.
- Life Cover Claims Queries and Complains
- Respond to and resolve claims queries and complaints within SLA's
- Work with the Complaints Management team to handle disputes and appeals related to death claims
- Stakeholder Engagement
- Build trusting relationships with both internal and external stakeholder to achieve Capitec Life Objectives
- Educate stakeholders on their responsibilities regarding the Claims Assessment Framework.
Skills
- Administration Skills
- Attention to Detail
- Decision making skills
- Numerical Reasoning skills
- Planning, organising and coordination skills
Conditions of Employment
- Clear criminal and credit record
Capitec is committed to diversity and, where feasible, all appointments will support the achievement of our employment equity goals.