The Team Leader – Corporate Claims and Benefits is responsible for leading the end-to-end claims administration for Group Life and Credit Life policies. The role ensures that claims are assessed and paid accurately, timely, and in accordance with policy terms, regulatory requirements, and reinsurance treaties. This position also provides oversight on claims quality, supports escalations, and contributes to continual improvement in claims service and controls.
Key Tasks and Responsibilities
Team Leadership: Lead, guide, and review the work of claims officers to ensure timely and accurate assessment of claims.
Complex Claims Management: Manage high-value or complex claims escalations, coordinating with underwriting, legal, reinsurance, and medical assessors as needed.
Service Level Management: Ensure claims turnaround times and service level agreements (SLAs) are consistently met across the portfolio.
Quality Assurance: Provide quality assurance by reviewing sampled claims decisions and audit feedback.
Risk Monitoring: Monitor trends in claims repudiations, fraud, and operational risk to propose preventive actions.
Cross-Functional Liaison: Liaise with finance and reinsurance teams to ensure proper funding, recoveries, and claims provisioning.
Reporting & Analytics: Support reporting and analytics on claims volumes, causes of claims, and portfolio loss ratios.
Mentorship: Mentor and support development of team members through regular coaching and performance feedback.
Regulatory Compliance: Ensure all claims operations comply with Anti-Money Laundering (AML) and Counter Financing of Terrorism (CFT) regulations, the Data Protection Act (DPA), and Insurance Regulatory Authority (IRA) claims settlement guidelines.
Compliance Oversight: Oversee screening of claimants and beneficiaries, and ensure suspicious claims are escalated to compliance in a timely manner.
Client Focus: Ensure continuous and professional communication with corporate clients and beneficiaries, especially on complex or sensitive claims.
Skills and Competencies
Advanced understanding of life insurance claims assessment and policy terms.
Strong people management and performance coaching skills.
Analytical thinking and ability to handle complex claims scenarios.
Excellent stakeholder engagement and communication abilities.
High integrity and attention to regulatory and audit requirements.
Effective in managing pressure and delivering under strict deadlines.
Knowledge and Experience
5+ years of experience in life insurance claims handling, with at least 2 in a leadership role.
Qualifications
Bachelor’s degree in Commerce (BCOM) or a business-related field.
Professional insurance qualification (e.g., AIIK, ACII, LOMA).
