Senior Life Claims Assessor | Hybrid + Growth & Benefits

Vitality; Sandton; Hybrid; ZAR 700,000 - 1,000,000; Full time

Benefits offered by this job

Bonus schemes

Retirement match up to 5%

Health & wellbeing – Discovery Medical

Life assurance and income protection

Disability insurance

Job summary

Vitality is seeking a Senior Claims Assessor to evaluate Income Protection claims, considering medical, financial and contractual factors to reach well‑evidenced decisions. The role focuses on high‑quality claims experience and will involve identifying potential fraud while engaging with stakeholders.

It also supports knowledge sharing and improvements to products and systems. The role requires depth of medical understanding and strong communication to explain decisions clearly, plus

Qualifications

• 3-5 years’ experience within a life insurance claims environment.
• Intermediate knowledge of the Life Insurance industry and claims management principles.
• Knowledge of medical conditions and diagnoses with application to claims assessment.
• Strong written and verbal communication skills.
• Proven ability to make sound decisions with minimal supervision.
• Experience collaborating with internal and external stakeholders to progress cases.

Responsibilities

• Assess Income Protection claims through detailed medical and financial assessment, aligning with industry best practice and service levels.
• Review evidence, policy terms and circumstances to determine contractual validity of claims.
• Identify potential fraud, misrepresentation and pre-existing conditions in complex cases.
• Collaborate with stakeholders to gather information and reach evidence-based decisions.
• Manage complaint resolution professionally and communicate decisions clearly.
• Apply medical knowledge to support accurate claims assessment.
• Share technical knowledge to strengthen team capability and consistency.
• Coach administrators to develop team capabilities.
• Contribute insights to product development and system enhancements.

Skills

Strong Income Protection Claims Assess

Proven Medical Claims Knowledge

Sound Complex Claims Judgement

Education

Certificate of Proficiency in life insurance

Medical degree or diploma

Tools

Microsoft Office (Outlook, Excel, Word)

Job description

Vitality is seeking a Senior Claims Assessor to evaluate Income Protection claims, considering medical, financial and contractual factors to reach well‑evidenced decisions. The role focuses on high‑quality claims experience and will involve identifying potential fraud while engaging with stakeholders.

It also supports knowledge sharing and improvements to products and systems. The role requires depth of medical understanding and strong communication to explain decisions clearly, plus