Claims Manager (Life/Medical Insurance), Durban at Pro Talent

• An established life insurer is seeking an experienced Claims Manager to lead and develop its Life and Medical Claims team. This is an excellent opportunity for a passionate claims professional with strong medical and insurance expertise to take ownership of a critical business function, drive operational excellence, and contribute to strategic decision-making.
• In this senior leadership role, you will oversee the end-to-end claims process, ensure fair and efficient claims assessments, manage risk, enhance customer experience, and lead a team of claims assessors and administrators. You will also play an influential role in product development, claims innovation, reporting, and stakeholder management.

Key Responsibilities

• Lead, mentor, and develop a team of claims assessors and administrators.
• Oversee the assessment and management of life insurance claims, ensuring service levels and quality standards are consistently met.
• Manage complex and escalated claims, liaising with legal advisors, reinsurers, and internal stakeholders where required.
• Drive continuous improvement initiatives, including process optimisation and automation opportunities.
• Monitor claims trends, identify risks, and provide detailed reporting and insights to senior leadership.
• Contribute to claims philosophy, product development, underwriting reviews, and risk management strategies.
• Build and maintain strong relationships with advisers, reinsurers, and key stakeholders.
• Ensure a customer-centric approach that balances empathy, fairness, and sound risk management.
• Manage team performance, capacity planning, training, recruitment, and budgeting.  

Requirements

• Degree or qualification in a medically related field such as Occupational Therapy, Physiotherapy, Biokinetics, or similar (preferred, not essential)
• Minimum 5 years’ life insurance claims assessment experience.
• Strong medical knowledge and understanding of life insurance principles.
• Proven leadership and people management experience.
• Excellent communication, negotiation, analytical, and decision-making skills.
• Ability to interpret complex insurance contracts and manage risk effectively.
• Strong problem-solving skills with a high level of attention to detail.