About The Role

Team – Claims

Working Pattern - Hybrid 2 days per week in the Vitality Sandton, Full time.

Key skills required for this role:

Medical & Claims Assessment Expertise
High‑Level Communication Skills (Written & Verbal)

As a Claims Assessor Specialist, you will be responsible for assessing Life Cover, Terminal Illness, and Critical Illness claims.

Although this role is primarily home‑based, there may be occasions when you are required to attend the office.

Responsibilities

Assess the validity of submitted claims, ensuring all decisions are made in accordance with industry‑leading UK claims practices. This includes reviewing medical and supporting evidence, obtaining further information where required, and drafting and issuing clear, accurate decision letters and related correspondence.
Identify potential concerns such as fraud, non‑disclosure, misrepresentation, or pre‑existing conditions.
Collaborate with strategic underwriters, management, reinsurers, and other key stakeholders to ensure fair, timely, and accurate claim outcomes.
Provide mentoring and coaching to junior team members, which may include facilitating case study sessions, delivering training on specialist topics, and supporting their technical development.
Assist in complaint resolution, ensuring thorough investigation and professional communication throughout the process.

Essential Skills & Experience

Experience assessing and managing Life Cover and tiered Critical Illness claims.
Strong understanding of the UK insurance market and regulatory environment.
Proven experience working with reinsurers.
Ability to present ideas confidently and deliver training to peers.
Advanced verbal and written communication skills.
Intermediate proficiency in Microsoft Word, Excel, PowerPoint, and other common Office applications.

About Us

Vitality South Africa plays a key role in the development and delivery of the shared‑value insurance model within the Discovery Group. The team leads key strategic initiatives in the South African market, strengthens alignment across the organisation, and ensures the successful implementation of Vitality’s health and wellness programmes. In addition, the team provides specialised expertise, cutting edge technology, behavioural science and health and wellness, drawing on both global innovation and local market insight. Roles within Vitality South Africa are dynamic and fast‑paced. As such, we are seeking individuals who are adaptable, solutions‑oriented, and capable of delivering high‑quality, sustainable value in a complex and evolving environment.

Employment Equity:

The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.

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