As a Senior Claims Consultant, you’ll play a critical role in our REST Claims team, guiding customers through life insurance claims with care, expertise, and efficiency. You will be responsible for the proactive management of a portfolio of Claims in accordance with TAL’s claims philosophy, claims handling procedures, policy terms & conditions and in accordance with the Life Insurance Code of Practice and other legislative and regulatory requirements. A key focus of this role involves providing a best-in-class customer and client (e.g. advisers, trustees, fund administrators) experience, including regular communication in relation to the status of claims and managing expectations, to deliver on quality health and claim outcomes. In this role you will:Manage a portfolio of complex Group Life claims, balancing customer needs with policy and business requirements.Communicate effectively with customers, advisers, and treating practitioners via phone and written correspondence.Interpret policy terms, underwriting decisions, and non-disclosure matters to determine claim eligibility.Analyse complex financial and medical information to make sound, evidence-based claims decisions.Develop and monitor Return to Work (RTW) plans in collaboration with customers and healthcare providers.Lead case conferences and employ strategies to gather critical information on customer conditions and work capacity.Collaborate with internal and external stakeholders, including underwriters, rehab consultants, legal and medical officers, and reinsurers.Mentor junior staff and contribute to technical leadership across the claims team.
