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Life Insurance / Group Insurance Claims Specialist

External
Kpmgaustralia1 logoKpmgaustralia1 · Melbourne, Australia
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About the role

KPMG's Claims and Workplace Health practice is seeking experienced Life and Group Insurance Claims Specialists who are passionate about improving claims outcomes and contributing to better industry practices. We partner with life insurers, self-insurers, schemes and employers to navigate complex challenges, enhance claims performance and deliver practical solutions that improve customer outcomes and operational effectiveness. Your Opportunity This is a key role across high-impact claim review and support programs focused on improving outcomes across life insurance portfolios. Working as part of a high-performing claims delivery team, you will apply your technical claims expertise to conduct strategic claim reviews, assess complex information and develop evidence-based recommendations that support timely claim progression and quality claim outcomes. This is a hands-on role requiring strong technical capability, sound judgement and the ability to analyse complex information in a fast-paced environment. You will play an important role in helping clients progress complex claims while maintaining positive customer outcomes, quality standards and regulatory compliance. We are seeking claims professionals to join on a 12-24 month maximum-term contract, with the opportunity to apply your life insurance claims expertise across diverse engagements and operating environments. The Impact You Will Make Be part of high-impact programs driving measurable improvements in claims outcomes and customer experience. Apply your expertise to complex and meaningful claims challenges across a range of life insurance environments. Work alongside experienced claims practitioners in a collaborative and high-performing team. Gain exposure to diverse insurers, operating models and claims portfolios. Contribute to initiatives that improve claim progression, consistency and quality outcomes at scale. Access opportunities to broaden your technical capability and work on engagements that influence claims strategy and best practice across the industry. How are you Extraordinary We are looking for people who bring: Strong analytical and critical thinking capability. Excellent written and verbal communication skills, with the ability to clearly articulate findings and recommendations. Strong attention to detail and commitment to quality. A proactive, outcome-focused approach to claims assessment and review. Ability to identify key issues, develop practical solutions and support claim progression. Strong stakeholder engagement skills and a customer-centric mindset. Proven ability to thrive in a fast-paced, high-volume environment. Prior experience in assessing Income Protection and Total and Permanent Disability claims, with exposure to additional life insurance product lines highly regarded.

Responsibilities

  • Conduct strategic reviews of Income Protection (IP) and Total and Permanent Disability (TPD) claims to identify the most appropriate pathway towards timely and sustainable claim outcomes.
  • Review, analyse and interpret medical, financial, vocational, employment and other relevant evidence.
  • Identify key claim issues, evidentiary requirements, liability considerations and barriers to claim progression.
  • Develop clear, evidence-based recommendations to support claim assessment, decision-making and claim advancement.
  • Apply policy terms, industry standards, legislation and procedural requirements accurately and consistently.
  • Assess appropriate next steps, evidence requirements and claim progression strategies to support efficient claim resolution.
  • Liaise with claimants, employers, medical practitioners, rehabilitation providers, reinsurers and other stakeholders to obtain information and support claim progression.
  • Support recovery, rehabilitation and return-to-work strategies where appropriate.
  • Prepare accurate file notes, assessment summaries, review outcomes and supporting documentation.
  • Escalate complex, sensitive or disputed matters appropriately and contribute to technical claim discussions and peer review processes.

Requirements

  • Demonstrated experience in Group Insurance and/or Life Insurance from an insurer perspective.
  • Technical proficiency in: Income Protection / Salary Continuance claims
  • TPD assessment and decision making
  • Demonstrated experience reviewing claims and making evidence-based recommendations to support quality claim outcomes.
  • Demonstrated experience reviewing claims and interpreting medical, financial, vocational and employment evidence.
  • Proven ability to identify key claim issues, evidentiary gaps and claim progression opportunities.
  • Experience applying policy provisions, legislation and claims frameworks within a regulated insurance environment.
  • Excellent written communication skills, including preparation of clear, concise and defensible assessment outcomes.
  • Strong stakeholder management and problem-solving capabilities.
  • If you're looking to apply your life insurance claims expertise in a role that impro

Benefits

Health insuranceVision insurance

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