Claims and Benefits Officer
Old Mutual South Africa · Nairobi
Job description
About the role
The Claims and Benefits Officer will manage end‑to‑end processing of Group Life and Credit Life claims, ensuring accurate assessment, timely handling and high‑quality service for clients and intermediaries. You will work closely with underwriting, reinsurance, legal and other internal teams to uphold policy terms, regulatory standards and risk‑mitigation practices.
Key responsibilities
- Register and acknowledge claims within agreed timelines, verifying completeness of documentation.
- Assess claims against policy terms, underwriting notes and reinsurance arrangements.
- Prepare claim summaries and recommendations for approval within internal authority limits.
- Coordinate with underwriting, reinsurance and legal teams to support defensible decisions.
- Communicate claim outcomes to clients, brokers and medical providers with empathy and professionalism.
- Maintain claims registers and contribute to analysis of claims experience and turnaround performance.
- Support escalations, compile evidence for disputed or declined claims, and ensure compliance with AML, DPA and IRA regulations.
- Conduct beneficiary verification and flag suspicious claims according to AML/CFT policy.
Required profile
- Bachelor’s degree in Commerce or a related business field.
- Professional insurance qualification (e.g., AIIK, ACII, LOMA) is desirable.
- 2–3 years of experience handling group life or credit life claims.
- Strong knowledge of life insurance claims principles and policy interpretation.
- Ability to work under pressure and coordinate across departments.
Required skills
- High attention to detail and accuracy in documentation.
- Empathy and emotional intelligence when dealing with bereaved clients.
- Analytical and problem‑solving capabilities for complex claim adjudication.
- Good written communication and reporting skills.
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Published 1 month ago
Expires 2 weeks from now
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Old Mutual South Africa
Nairobi
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