Objectives

The primary objective is to obtain an independent, expert assessment of Land Bank Insurance Company SOC Ltd’s (LBIC) current claims management environment. The engagement aims to identify operational gaps, inefficiencies, and compliance risks while developing actionable recommendations for an optimal future-state claims management operating model. The ultimate goal is to establish a cost-effective, efficient, and compliant claims function that aligns with agricultural and commercial insurance industry standards.

Scope of Work

The service provider will conduct a comprehensive diagnostic and strategic redesign of LBIC’s claims operations. Key deliverables include:

• Current State Assessment: Evaluate roles, responsibilities, governance structures, delegated authorities, internal/outsourced functions, and cross-functional interactions.
• Policy & Control Review: Audit claims policies, approval workflows, quality assurance, fraud controls, compliance protocols, and record-keeping practices.
• Resource & Capacity Analysis: Assess staff skills, competencies, and workload capacity; recommend optimal organizational structure and resourcing.
• Technology & Systems Evaluation: Review workflow automation, digital processing, document management, reporting tools, data analytics, and system integrations.
• Data & Performance Analysis: Analyze claims volumes, turnaround times, outstanding backlogs, repudiation rates, costs, and complaint metrics to identify trends and inefficiencies.
• Benchmarking: Compare LBIC’s claims environment against industry peers across operating models, service levels, staffing, technology, governance, costs, and customer experience.
• Operating Model Design: Develop and evaluate four alternatives: In-House, Outsourced, Hybrid, and a custom recommended model.
• Implementation Roadmap: Provide a phased execution plan covering short-, medium-, and long-term activities, resource allocation, and transition steps.

Technical Requirements

Bidders must satisfy mandatory eligibility criteria before technical scoring. Required submissions include:

• A company profile demonstrating proven experience in insurance claims management, advisory services, and operating model design (covering motor and non-motor lines).
• Three client testimonials or reference letters from the financial services sector confirming similar engagements.
• Proof of professional indemnity and fidelity insurance with coverage of at least R1 million.
• A completed pricing schedule with fixed fees broken down per deliverable. No post-submission price adjustments will be accepted.

The technical evaluation uses a 100-point scale, requiring a minimum threshold of 70 points to advance. Scoring weights: Portfolio evidence (30 points), project plan and deliverables (25 points), methodology and approach (25 points), team qualifications (10 points), client references (10 points), and assignment understanding (10 points). All bidders must submit statutory compliance documents, including a valid Tax Compliance Status PIN, B-BBEE certification, FICA/KYC records, and signed confidentiality and conflict-of-interest declarations.

Skills Requirements

The successful bidder must demonstrate deep expertise in insurance claims transformation, particularly within agricultural and commercial portfolios. Essential competencies include:

• Claims Process Optimization: Ability to map end-to-end claims workflows, identify bottlenecks, and design streamlined procedures.
• Operating Model Architecture: Experience structuring hybrid, outsourced, or in-house claims functions with clear governance and accountability frameworks.
• Data Analytics & Benchmarking: Proficiency in interpreting claims KPIs, conducting gap analyses, and comparing performance against industry benchmarks.
• Project Management: Capability to develop logical work plans, track milestones, manage dependencies, and deliver measurable outcomes on schedule.
• Regulatory & Compliance Knowledge: Familiarity with insurance sector regulations, fraud prevention controls, and risk management standards.
• Team Qualifications: The lead advisor must possess over five years of relevant experience, supported by verifiable positive client references. The broader team should collectively cover strategy, actuarial/claims analytics, technology integration, and change management.

Procurement & Regulatory Terms

This tender utilizes an 80/20 preference point system, where 80 points are allocated to competitive pricing and 20 points to Broad-Based Black Economic Empowerment (B-BBEE) status. Bidders must submit valid B-BBEE certificates or sworn affidavits to claim these points. The evaluation also incorporates FSCA regulatory compliance, referring to the Financial Sector Conduct Authority’s oversight framework governing insurance market conduct, solvency, and consumer protection. Unusually high or low pricing may trigger a financial risk analysis to verify cost reasonableness and prevent market distortion. All personal information submitted will be processed in accordance with data protection legislation, and bidders must execute confidentiality agreements to safeguard sensitive bank data.