Member Care Life - Escalation Manager

About Discovery

Discovery’s core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values align with those of Discovery. Our fast-paced and dynamic environment enables smart, self-driven people to be their best. As global thought leaders, Discovery is passionate about innovating to not only achieve financial success, but to ignite positive and meaningful change within our society.

About the VitalityLife 

A dynamic team with a wealth of knowledge which we eagerly share. We strive to be the best in the market, living the Discovery values. Our motto is best terms first – right decision…first time…on time…every time.

Key Purpose

The Life Claims Escalations Manager is responsible for overseeing the resolution of complex, high-priority, or disputed life insurance claims. This role ensures escalated cases are handled with accuracy, empathy, and in compliance with regulatory and company standards. The manager acts as a key liaison between internal teams, customers, legal advisors, and regulatory bodies, ensuring timely and fair outcomes.

Areas of responsibility may include but not limited to

• Escalation Management:
  Handle and resolve escalated life insurance claims, including those involving disputes, complaints, or exceptional circumstances.
• Stakeholder Communication:
  Act as the primary point of contact for internal departments, policyholders, beneficiaries, legal representatives, and ombudsman services regarding escalated claims.
• Case Review & Decision Making:
  Conduct thorough reviews of claim files, medical records, policy terms, and supporting documentation to make informed decisions.
• Compliance & Risk Oversight:
  Ensure all escalated claims are managed in line with FCA regulations, company policies, and industry best practices.
• Process Improvement:
  Identify trends in escalations and contribute to continuous improvement initiatives to reduce future escalations and enhance customer experience.
• Team Leadership & Support:
  Provide guidance and support to claims handlers on complex cases and act as a mentor for developing claims expertise.
• Reporting & Insights:
  Maintain accurate records of escalated cases and produce regular reports for senior management, highlighting key metrics and insights.

Education and Experience

Essential Key Qualifications and Experience

• Experience in life insurance claims handling, ideally with exposure to escalations or complaints.
• Strong understanding of life insurance products, policy terms, and claims processes.
• Excellent communication and negotiation skills, with the ability to manage sensitive conversations.
• High attention to detail and analytical thinking.
• Knowledge of regulatory frameworks (e.g., FCA, TCF, GDPR).
• Experience working with legal teams or ombudsman services is advantageous.
• Proficiency in claims management systems and Microsoft Office tools.

Key Competencies:

• Customer Focus
• Decision Making
• Emotional Intelligence
• Conflict Resolution
• Regulatory Awareness
• Leadership & Influence

EMPLOYMENT EQUITY   
                             
The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.