Claims Investigation and Data Support Specialist

Discovery Limited; Sandton; On-site; ZAR 240,000 - 420,000; Full time

Job summary

Discovery Limited in South Africa seeks a Claims Assessor Specialist within Discovery Life to assist claims investigations and support the legal, medical and claims teams in adjudicating death, disability and severe illness claims. You will gather evidence, liaise with third parties, and help detect high-risk claims to ensure accurate assessments.

The role emphasizes data analysis, court testimony, and strong communication with government officials and internal assessors, with emphasis on

Qualifications

• Matric required with strong academic results.
• PSIRA registration is mandatory.
• Experience in investigations and security environment is advantageous.
• Minimum 5 years in relevant roles.

Responsibilities

• 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
• Action orientated
• Interpersonal savvy
• Situational adaptability

Skills

Data Analysis

Communication skills

Testify in court

Investigations

Education

Matric

PSIRA registered

General Investigations

Job description

Discovery Limited in South Africa seeks a Claims Assessor Specialist within Discovery Life to assist claims investigations and support the legal, medical and claims teams in adjudicating death, disability and severe illness claims. You will gather evidence, liaise with third parties, and help detect high-risk claims to ensure accurate assessments.

The role emphasizes data analysis, court testimony, and strong communication with government officials and internal assessors, with emphasis on