Claims Assessing Manager at Discovery Limited

Key Purpose 

• To lead and manage the effective operations within the Short-Term Insurance investigations teams and all associated administration and support functions relating to teams and relative stakeholders.
• Drive, implement and manage set strategy and targets for the area and provide a service of high standards. The role focuses on ensuring the validity of claims based on the Discovery Insure contract, detecting potential fraud, and supporting fair and accurate claims resolution.
• This includes implementing investigation strategies, ensuring compliance with legal and regulatory standards, and collaborating with internal and external stakeholders to protect the company from financial losses due to fraudulent claims.

Areas of responsibility may include but not limited to 

• Full line management function within scope of roll
• Monitor investigations, performance metrics and teams’ outputs to identify trends, improve processes, and ensure alignment with business objectives.
• Compile and present monthly investigation performance reports to senior management to provide insights into fraud trends, team productivity, and operational risks.
• Implement investigation strategies across the team to improve detection of fraudulent claims and enhance operational efficiency.
• Collaborate with internal and external stakeholders (e.g., actuaries, legal, underwriting, law enforcement, SAICB) to resolve high-risk claims and support legal proceedings when necessary.
• Oversee investigations into suspicious or complex high quantum claims to ensure accurate claim outcomes and minimize fraud-related losses.
• Provide training and mentorship to investigation staff to build technical capability, promote ethical practices, and maintain high investigation standards
• Cultivate Discovery culture within business are
• Effectively manage operating costs within the call centre as per budget

Education and Experience 

• Matric (Essential)
• Minimum of 8 years’ short term insurance claims experience (Essential)
• Minimum of 3 years’ leadership and management experience of an investigations team (Essential)
• Higher Certificate or Diploma in Short-Term Insurance (Advantageous)
• ACFE (Advantageous)
• Diploma or Degree in Insurance, Risk Management, or Forensic Investigation (Advantageous)
• Motor Industry-related qualification (e.g., Motor Assessing, or Mechanical Technology) (Advantageous)