Technical Specialist, Retail Income Protection Claims

The Technical Claims Specialist sits at the centre of quality and decision integrity, providing expert review and guidance on lump sum claims. The role ensures fair, consistent outcomes in line with TAL’s philosophy and regulatory standards, while elevating the customer and client experience through coaching, clarity of communication, and strong technical leadership.

• Act as a subject matter expert, responding to Claims Consultant requests and enquiries and to authorise and review claims (and associated benefits payments)
• Provide adverse decision review and sign off on assessment, which may require referral to internal Claims review body
• Coaching Claims Consultants in appropriately executing assessment practices ensuring the timely and quality management of claims. Including completing ‘above delegation’ and ‘within delegation’ reviews of individuals work and recording outcomes and opportunities for development 
• Support Client Managers and Team Managers in their reporting to funds and attendance at fund meetings/case conferences related to technical claim outcomes as required
• Development/ enhancement of claims handling procedures and guidelines as required. 
• Review, advise and sign off (within delegation) on policy T&Cs within internal forums, communicating the outcome of approved policy T&Cs within team to ensure understanding/application
• Ensure compliance with TAL policies, procedures and guidelines procedures, ensuring claims management is in accordance with the TAL claims philosophy as well as to external regulators (eg. Privacy and Life Insurance Code of Practice) and all relevant legislation and industry guidelines