Group Claims Team Leader

SUMMARY:
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POSITION INFO:

Purpose of the Role:

At Dis-Chem Life, claims are the heart of our business - the moment when our promise becomes real. This is not a transactional role. It is the embodiment of trust, accountability, and operational excellence at scale.

The Group Claims Team Leader is responsible for the end-to-end management, governance, and performance of the claims function for Dis-Chem Life Group benefits. This role ensures that every claim is handled fairly, efficiently, compliantly, and consistently - while driving automation, customer experience excellence, and continuous improvement across the entire claims team.

Your mission: to build and lead a high-performing claims operation that balances compassion with compliance, speed with accuracy, and customer trust with fraud vigilance. You will shape processes, mentor teams, deliver insights, and protect the integrity of our claims promise.

Role Summary:

This role is responsible for leading the claims team, overseeing all group claims assessments, and ensuring operational excellence in claims processing, governance, and stakeholder engagement. The Group Claims Team Leader will manage claims assessors, streamline workflows, ensure regulatory compliance, and drive continuous improvement across the claims function.

To succeed, you must be both strategically minded and operationally excellent - able to lead people, manage complex stakeholder relationships, interpret policy with precision, and balance empathy with accountability. You will own claims performance metrics, monthly reporting, fraud detection protocols, and the development of your team.

This is a leadership role for someone who thrives in high-volume, high-stakes environments and can elevate claims operations across our business. 

Benefits:

• Competitive Salary
• Opportunities to grow within a fast-scaling insurance business
• Potential to progress into senior leadership roles as the company evolves
• Access to ongoing training and development programs to build claims and leadership expertise
• Exposure to modern claims management systems and tools
• Be part of shaping the claims function of a growing life insurance company
• Flexible working hours with hybrid options
• Visionary Leadership

Key Responsibilities:

Enhancing the Group claims management framework by: 

• Streamlining claims processing, ensuring efficiency and accuracy 
• Managing Group claims assessors and overseeing the decision-making on Group claims 
• Monthly reporting on Group claims, trends and key findings 
• Robust documentation and record keeping for meticulous record management 
• Stakeholder engagement with internal teams, Group Human Resources departments and external vendors, including reinsurers and underwriters 
• Lead and mentor claims teams 
• Foster a culture of accountability, professionalism and customer empathy 
• Ensure all compliance, regulatory and contractual governance standards are met and exceeded  

Soft Skills:

• Demonstrates high empathy and emotional intelligence, providing compassionate support to grieving clients while maintaining professional composure
• Strong leadership and people management skills with ability to develop and motivate teams
• Maintains strong attention to detail, ensuring accuracy in claims assessment and documentation
• Communicates clearly and sensitively, both verbally and in writing, explaining processes and outcomes to clients and stakeholders
• Remains resilient under pressure, managing high volumes of claims without compromising quality
• Exhibits integrity and ethical decision-making in all claims-related activities

Technical Skills:

• Solid knowledge of insurance principles claims processes, and policy wordings
• Proficiency in claims management systems and Microsoft Office Suite
• Ability to accurately calculate claim benefits and apply policy conditions
• Working knowledge of regulatory frameworks (FSCA, TCF, POPIA)
• Strong fraud awareness and escalation judgment

Experience:

• 5 – 8 years’ experience in group risk benefits claims or group claims 
• Strong track record in working in a high-volume claim’s environment
• Hands-on experience with policy interpretation, exclusions, and regulatory compliance
• Exposure to fraud investigation or fraud detection in insurance (advantageous)

Qualifications:

• Matric (Grade 12) required.
• Diploma or degree in Insurance, Finance, or related field advantageous.
• Relevant insurance/claims certifications or FAIS compliance (advantageous)
• Clear credit and criminal record