L&H Claims Specialist
Swiss Re
Cape Town, Western Cape, ZA
3d ago

About Swiss Re

Swiss Re is one of the world’s leading providers of reinsurance, insurance and other forms of insurance-based risk transfer, working to make the world more resilient.

We anticipate and manage a wide variety of risks, from natural catastrophes and climate change to cybercrime.

At Swiss Re we combine experience with creative thinking and cutting-edge expertise to create new opportunities and solutions for our clients.

This is possible thanks to the collaboration of more than 13,000 employees across the world.

We offer a flexible working environment where curious and adaptable people thrive. Are you interested in joining us?

The role in Johannesburg will be teleworking.

The role in Cape Town will be office based.

The opportunity

Are you an experienced Claims Specialist with passion for life & health products? Are client needs always your priority?

Then we are looking you!

You will get a chance to effectively manage our claim liability through implementing appropriate client and claims management / risk management strategies.

You will work closely with Client Markets and Underwriting to provide outstanding service to our Clients and collaborate with Actuarial Team for Claims Data analysis and interpretation with appropriate feedbacks to future Product development and Pricing as well as suggest appropriate interventions to improve the portfolio experience.

You will be responsible for :

  • Assesses and manages claims, implementing effective claims management strategies with clients, in accordance with the terms and conditions of the policy, claims philosophy and pricing assumptions.
  • Inputs and maintains internal claim and other records in an accurate manner.
  • Responds to clients and internal colleagues speedily and professionally in line with service standards and expectations.
  • Performs client audits according to the audit framework, and agrees remedial actions to improve claims standards.
  • Works closely with team members in managing client relationships, providing solutions and valuable claims services, including training, thought leadership, seminars, meetings, etc
  • Supports the Business Unit in tendering for new business, innovative product development and in promoting our claims profile and expertise in the market.
  • Ensures treaty documentation matches terms and conditions agreed, and relevant claims clauses and articles meet Swiss Re's standards.
  • Analyses performance of client portfolio to identify trends, risks and opportunities, ensuring we are involved where and only where Swiss Re adds value.
  • Ensures required claims data and reports are accurate and complete for business reporting purposes.
  • Supports the Claims Manager in developing client portfolio management strategy and planning.
  • Contributes to EMEA-wide activities and initiatives as appropriate.
  • About you

    We are happy to welcome in our team :

  • Relevant formal qualification in the financial services / law / health field, and 5 to 10 years experience with a full claims approval authority in direct insurer or reinsurer claims management (in life insurance products including Death, Critical Illness and Disability Insurance).
  • Specialist in the legal aspects of life insurance, its principles and practice.
  • Client relationship management experience with the interpersonal skills to carry out these responsibilities.
  • Design of policy wording and definitions for disability income, critical illness, TPD, and life products.
  • Excellent oral and written communication skills in English.
  • Experience of delivering training and presentations to a professional audience.
  • Auditing experience.
  • Management of claim disputes and litigation / Ombudsman referrals.
  • Data Analytical skills a must.
  • Travel in Southern Africa to meet and visit clients is a requirement for the job, as is occasional travel to other African countries.
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