Claims Assessor Specialist

FirstRand Life Assurance Ltd; Johannesburg; On-site; ZAR 360,000 - 600,000; Full time

Benefits offered by this job

Opportunities to network and collab.

Challenging working environment

Innovative culture

Job summary

FirstRand Group's FR Life Assurance seeks a dedicated Loss Claims Assessor to evaluate long-term insurance claims including impairment, disability, income replacement, death and critical illness. You will investigate, assess, and ensure decisions align with policy terms and company values.

Ideal candidates hold a medical qualification (Occupational Therapy, Physiotherapy, or Biokineticist) with at least 3 years of medical claims experience in long-term insurance, and familiarity with Ombudsman

Qualifications

• Medical qualifications and medical claims assessment experience.
• Experience in long-term insurance and Ombudsman processes.
• Exposure to policy interpretation and claim investigations.

Responsibilities

• Accurately assess, investigate and manage long-term insurance claims including impairment, disability, income replacement, death and critical illness.
• Ensure that the claims assessment and the standard of decision is consistent with the company values and philosophy.
• Identify fraudulent activity, policy abuse and pre-existing conditions and escalate as needed.
• Provide effective, efficient and professional service to customers, advisors and branches, telephonically and in writing.
• Take ownership of queries and resolve them timeously and effectively.
• Adhere to organizational best practice and legislative requirements.
• Collaborate with the team to meet service and quality standards.
• Deliver exceptional service with proactive, innovative, and appropriate solutions.

Skills

Claims assessment

Fraud detection

Customer service

Education

Occupational Therapy

Physiotherapy

Biokineticist

Tools

ASISA course

Job description

Job Description To apply loss control processes within the organisation, including the follow up of special investigations and monitoring recovery Hello Future Risk Claims Assessor, Welcome to FNB, the home of the #changeables. We design for the shapeshifters and deliver products and services that make us incredibly proud of people that make it happen. As part of our talented team in FR Life Assurance, you will be surrounded by unique talents, diverse minds, and an adaptable environment that lives up to the promise of staying curious. Now's the time to imagine your potential in a team where experts come together and ignite effective change

Key Responsibilities

• Accurately assess, investigate and manage long-term insurance claims including Impairment, Disability, income replacement, death and critical illness claims.
• Ensure that the claims assessment and that the standard of decision is consistent with the company values and philosophy.
• Ensure all risks are mitigated and escalated; this includes the identification of fraudulent activity, policy abuse and pre-existing conditions.
• Provide effective, efficient and professional service to all our customers, advisors and branches, both telephonically and through written correspondence.
• Take ownership of queries and ensuring they are resolved timeously and effectively.
• Ensure adherence to organizational best practice and legislative requirements.
• Teamwork to meet service and quality standards.
• Deliver exceptional service that exceeds customers' expectations through proactive, innovative and appropriate solutions.

Ideal Candidate

• Have a suitable medical qualification (Occupational Therapy, Physiotherapy and or biokineticist)
• At least 3 years' medical claims assessment experience
• Worked in a Long-term insurance environment.
• Experience in dealing with Ombudsman / escalated queries.
• Nursing background will be advantageous.
• ASISA Life insurance claims assessor course as a requirement- would be advantagous

Benefits

• Opportunities to network and collaborate.
• A challenging working environment
• Opportunities to innovate.

Job Fit

• Adaptable and curious
• Have a proven successful track record.
• Thrive in a collaborative environment.

Important Closing Date

Important Closing Date Note. Take note that applications will not be accepted on the below date and onwards, kindly submit applications ahead of the closing date indicated below. 18/11/26.

Inclusive Employment

All appointments will be made in line with FirstRand Group's Employment Equity plan. The Bank supports the recruitment and advancement of individuals with disabilities. In order for us to fulfill this purpose, candidates can disclose their disability information on a voluntary basis. The Bank will keep this information confidential unless we are required by law to disclose this information to other parties.

FirstRand provides a comprehensive range of financial services in South Africa and certain markets in broader Africa. The group also offers certain niche products and services in the UK and India. Listed on the Johannesburg Stock Exchange (JSE) and the Namibian Stock Exchange (NSX), FirstRand Limited is the largest financial institution by market capitalisation in Africa. The group follows a multi-branding approach. Its portfolio of financial services businesses includes FNB, RMB, WesBank, Ashburton Investments, Aldermore, MotoNovo and DirectAxis. Many are leaders in their respective segments and markets, offering transactional, lending, investment and insurance products and services. The FirstRand Corporate Centre houses many of the critical functions required by a large and complex financial services group. The group's track record of delivering superior returns to shareholders has been achieved through a combination of organic growth, acquisitions, innovation and the creation of completely new businesses. The group's purpose of delivering Shared Prosperity provides many opportunities for employees to innovate to address social and environmental challenges in our markets. All of our businesses have successful Volunteering programmes which also allow employees to adopt and support causes close to their hearts.