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Seniority (Banking, microfinance, insurance)
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Old Mutual
Banking + 2 more
Description
KNOWLEDGE & EXPERIENCE
- 5+ years of experience in life insurance claims handling, with at least 2 in a leadership role
4. QUALIFICATIONS
- Bachelor’s degree in Commerce (BCOM), or a business-related field
- Professional insurance qualification (e.g., AIIK, ACII, LOMA)
SKILLS AND COMPETENCIES
- Advanced understanding of life insurance claims assessment and policy terms
- Strong people management and performance coaching skills
- Analytical thinking and ability to handle complex claims scenarios
- Excellent stakeholder engagement and communication abilities
- High integrity and attention to regulatory and audit requirements
Effective in managing pressure and delivering under strict deadlines
Responsibilities
- Lead, guide, and review the work of claims officers to ensure timely and accurate assessment of claims
- Manage high-value or complex claims escalations, coordinating with underwriting, legal, reinsurance, and medical assessors as needed
- Ensure claims turnaround times and service level agreements are consistently met across the portfolio
- Provide quality assurance by reviewing sampled claims decisions and audit feedback
- Monitor trends in claims repudiations, fraud, and operational risk to propose preventive actions
- Liaise with finance and reinsurance teams to ensure proper funding, recoveries, and claims provisioning
- Support reporting and analytics on claims volumes, causes of claims, and portfolio loss ratios
- Mentor and support development of team members through regular coaching and performance feedback
- Ensure all claims operations comply with Anti-Money Laundering (AML) and Counter Financing of Terrorism (CFT) regulations, the Data Protection Act (DPA), and Insurance Regulatory Authority (IRA) claims settlement guidelines
- Oversee screening of claimants and beneficiaries, and ensure suspicious claims are escalated to compliance in a timely manner
- Client focus: Ensure continuous and professional communication with corporate clients and beneficiaries, especially on complex or sensitive claims
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