Living Benefits Claims Consultant

Sanlam; Bellville; On-site; ZAR 300,000 - 500,000; Full time

Job summary

Sanlam Life and Savings seeks a candidate for a role assessing complex living benefits claims. The successful applicant will possess knowledge in claims administration, complaint handling, and relevant experience as an Occupational Therapist or in a clinical role. The position requires good communication skills and the ability to manage complex scenarios independently.

Qualifications

• 3 to 5 years experience in the assessment of Living Benefit Claims.
• Experience as an Occupational Therapist or clinical role in the medical field.
• Experience in complaints handling.

Responsibilities

• Assessment and independent decision making of complex living benefits.
• Liaise with relevant stakeholders to resolve complex assessments.
• Taking full ownership for the communication of the outcome of the claim.

Skills

Claims administration

Claims settlements of a complex nature

Claims approvals and rejections

Claims handling

Education

Degree or Diploma

Job description

Who are we?

Sanlam Life and Savings (SLS) is focused on serving our retail and corporate clients in South Africa and further developing our strategic advantages in the South African market. Sanlam Life and Savings consists of the following business units Retail Mass, Corporate, Risk and Savings, Glacier and various business enabling functions. The Sanlam Life and Savings Office provides strategic direction, coordination and support to the four clusters, as well as performing governance oversight that includes assurance provided by second line of defense functions in SLS, to enable us to meet our business objectives.

What will you do?

• Assessment and independent decision making of complex living benefits e.g. severe illness, disability and sickness benefit claims.
• Ensure that the client’s claim request is met within the boundaries of the policy contract, which includes the interpretation of contractual definitions.
• Liaise with relevant stakeholders (e.g. Underwriters, Legal Department, Product Development, Medical Doctors, Re-insurers) to resolve complex assessments.
• Propose improvements to the assessment process.
• Written and verbal communication with clients, intermediaries, underwriters and doctors during the assessment process and on outcome of the claim.
• Taking full ownership for the communication of the outcome of the claim to the client and intermediary that enables them to understand the decision and prevent complaints.
• Complaints handling.
• Contact person to VIP intermediaries for technical enquiries and their client’s claims.

What will make you successful in this role?

Knowledge & Experience:

• Experience as an Occupational Therapist or clinical role in the medical field
• 3-5 years experience in the assessment of Living Benefit Claims or Risk claims or Retail claims is recommended.
• Experience in complaints handling
• Knowledge of Risk Products and Benefits is recommended

Competencies:

• Manages complexity
• Good communication skills in English and Afrikaans (written and verbal)
• Working independently

Qualification and Experience:

Degree or Diploma with 3 to 5 years related experience.

Knowledge and Skills Claims administration Claims settlements of a complex nature Claims approvals and rejections Operate within claims guidelines and compliance Coach and develop others Personal Attributes Business insight - Contributing independently Manages complexity - Contributing independently Plans and aligns - Contributing independently Manages conflict - Contributing independently Build a successful career with us

We’re all about building strong, lasting relationships with our employees. We know that you have hopes for your future – your career, your personal development and of achieving great things. We pride ourselves in helping our employees to realise their worth. Through its five business clusters – Sanlam Fintech, Sanlam Life and Savings, Sanlam Investment Group, Sanlam Allianz, Santam, as well as MiWay and the Group Office – the group provides many opportunities for growth and development.

Core Competencies Cultivates innovation - Contributing independently Customer focus - Contributing independently Drives results - Contributing independently Collaborates - Contributing independently Being resilient - Contributing independently Turnaround time

The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of managers.

Closing Date: 18 June 2025

Our commitment to transformation

The Sanlam Group is committed to achieving transformation and embraces diversity. This commitment is what drives us to achieve a diverse, inclusive and equitable workplace as we believe that these are key components to ensuring a thriving and sustainable business in South Africa. The Group's Employment Equity plan and targets will be considered as part of the selection process.