Main Responsibilities:

• Lead the Claims team to handle all types of claims from the clients (e.g. Death, CI, hospitalization, accident claims, etc.) and achieve our commitment of claims turnaround time
• Monitor and evaluate the performance of claim assessors and provide technical training and coaching to them
• Review guidelines/ manuals, service standards and the workflows in relation to claims.  Ensure all team members follow the related guidelines/ manuals and workflows so that to meet the service standards and enhance the smoothness of the daily claims operation
• Evaluate and approve all types of claims applications with the assigned authority
• Handle claims complaint received from client and regulator such as ICB
• Perform the investigation of suspicious/ fraudulent claims and ensure timely report to Management
• Participate in product development, comment on the product features / suggest possible product features to Product Development team from claims perspectives.  Provide comment on user requirements in relation to claims
• Conduct Quality Assurance review to maintain good quality for claims settlement
• Review and update claims forms in order to enhance the customer experience
• Deliver training to agents and staff of other departments in claims area if necessary
• Ensure timely report of Claims related KRI to Risk; Prepare claims statistics to Management
• Communicate with reinsurer on claims cases handling and seek for their support when necessary
• Assist to review reinsurance treaty for claims section to ensure the claims benefit is well defined

•   Academic & Professional Qualifications
  • Degree Holder
  • Fellow, Life and Management Institute (Preferred)
  • Associate Life and Health Claims
• At least 10 years of Life and Medical claims assessment experience
• At least 5 years in managing the Claims department
• Proficiency in English and Chinese; Fluent in Mandarin would be an advantage
• Strong customer-oriented mindset and skills
• In-depth knowledge in life insurance
• Effective communication skills and high level of integrity

(All personal data collected will only be used for recruitment purposes. Please visit https://www.tahoelife.com.hk/tl/en/privacy_policy/index.html for details of the “Privacy Policy Statement” of Tahoe Life.)

Tahoe Life Insurance Company Limited is a wholly-owned subsidiary of Tahoe Investment Group Company Limited.  Adhere to the aspiration of fulfilling social responsibility, we endeavor to serve our customers with sincerity, creating a brilliant future for our customers and the enterprise.

As the core business of Tahoe Investment’s financial arm, we are dedicated to offering comprehensive wealth management and life planning services.  We strive to be the leader in the high-end life insurance sector, taking care of our customers’ life cycles.