Claims Investigator and Assessor at Sanlam Group

What will you do?

• This is a specialist position that reports directly to Operations Manager: Claims.  The role is accountable for undertaking investigations to verify the validity of claims.   Additionally, the execution of a compliant and effective claims administration function (either Life or Funeral, or both in some cases).  

Key responsibilities include:

• Undertake claims investigations with external parties
• Build external partner relationships
• Assess and execute Life claims
• Assess and execute Funeral claims

What will make you successful in this role?

Qualification & experience 

• Grade 12 or preferably business or commerce degree/diploma
• 3 years’ experience as a claims assessor with specific focus in forensics investigation with external parties.
• Experience in financial distribution services, preferably re-assurance
• Assessor certification 
• Successful candidate must be willing to travel

Knowledge and skills 
IT:

• MS: Office (Excel, Word, PP, Outlook)
• MIS
• Thought Express

Business:

• Financial services industry knowledge 
• MiWayLife business and operating model 
• Financial services product knowledge (MiWayLife)
• Relevant regulatory legislation and compliance knowledge (POPI etc)
• Policy contracts governances, clauses, cover
• Claims and assessor principles, processes and governances 
• Underwriting processes and guiding principles (basic) 
• Medical/health assessment indicators and metrics
• Legal investigative processes (including affidavits)
• Criminal/SAPS procedures (processing cases)
• Call centre and sales processes
• Client complaints processes

Personal attributes

• Tenacity and determination
• Good communicator/confident/assertive
• Analytical and detail minded
• Curious and investigating orientation
• Sound ethics
• Client orientated 
• Financial acumen
• Problem solver
• Able to build relationships/partnerships
• Planning and organising orientation 
• Quality orientation