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Technical Claims Assessor

Vacancy Details

Reference No.



An established financial services provider is currently seeking an individual to assume the role of Technical Claims Assessor. The successful incumbent will be responsible for providing claims administration support concerning short term insurance matters to stakeholders while remaining in line with the organisation’s overall strategy.


  • Participate and support corporate social responsibility initiatives for the achievement of key business strategies.
  • Identify and recommend opportunities to enhance processes; systems and policies and support implementation of new processes; policies and systems.
  • Initiate and process claims to finalisation by ensuring compliance to insurance policy.
  • Comply with Service Level Agreements by adhering to self-imposed standards and timeframes.
  • Minimise risk by complying with all organisational policies and procedures.
  • Keep abreast of legislation and other industry changes that impacts on role by reading the relevant newsletters; websites and attending sessions.
  • Understand and embrace the organisations vision and demonstrate the values through interaction with team and stakeholders.
  • Improve personal capability and stay abreast of developments in field of expertise by identifying training courses and career progression for self through input and feedback from managers.
  • Ensure personal growth and enable effectiveness in performance of roles and responsibilities by ensuring all learning activities are completed; experience practiced and certifications obtained and/or maintained within specified time frames.
  • Ensure information is provided correctly to stakeholders by maintaining and sharing knowledge with team.
  • Comply with Service Level Agreement or Claims Protocol by administering and facilitating the claims process.
  • Reduce risk to the organisation by monitoring; identifying and reporting trends in claims.
  • Drive and support effective teamwork within the department.
  • Engage in appropriate training interventions to promote own professional development.
  • Ensure to demonstrate the company's values on a daily basis.
  • Adhere to organisational best practice and legislative requirements.
  • Ensure effective claims management service delivery and support.
  • Perform an efficient and accurate administrative function.
  • Identify and investigate all possible non-disclosure of pre-existing conditions.
  • Validate all claims, and ensure they are correctly completed and indexed.
  • Adhere to policies and procedures and take corrective action where necessary.
  • Ensure all risks are mitigated and escalated where necessary.


  • Matric / Grade 12 / National Senior Certificate.
  • Higher Certificate: Short Term Insurance.
  • OT qualification (or similar).
  • 3 to 5 years’ experience in a Claims environment.
  • Knowledge of Life Insurance advantageous.
  • Knowledge of insurance and industry legislation advantageous.
  • Life Insurance qualification.

Kindly note, if you have not heard from us within two weeks of your application please consider it unsuccessful.

Position Type


Work Level



Market Related


Banking/Finance And Investment

Salary Type



Cost To Company

Affirmative Action


Geographic Location

Kwazulu Natal - Durban