The Team Leader – Retail Claims is responsible for overseeing the end-to-end processing of retail life claims, ensuring timely adjudication, regulatory compliance, leading and motivating a team and high levels of customer satisfaction. The role provides technical guidance, quality control, and performance oversight to claims officers, while also handling escalated or complex claims directly. The position plays a key role in upholding trust in the claims process and strengthening customer loyalty.
1. KEY TASKS AND RESPONSIBILITIES
- Supervise the assessment and processing of individual life claims, ensuring adherence to SLA, policy terms, and regulatory guidelines.
- Review high-value or complex claims and provide technical input on eligibility and documentation.
- Collaborate with medical providers, reinsurers, and internal stakeholders for effective claims resolution.
- Track and report claim trends and develop initiatives to manage service quality
- Lead initiatives to improve claims efficiency, reduce leakage, and mitigate operational risks
- Conduct regular team meetings, coaching and performance evaluations to direct reportees.
- Ensure all claims practices are aligned with the Anti-Money Laundering (AML) Act, the Data Protection Act (DPA), and Insurance Regulatory Authority (IRA) guidelines.
- Ensure screening and verification of claimants and beneficiaries, and escalate any red flags or fraud indicators in accordance with internal compliance policies
2. SKILLS AND COMPETENCIES
- Expertise in life claims assessment and policy interpretation.
- Strong team leadership and quality control skills.
- Empathy and customer orientation in sensitive claim situations.
- Analytical mindset and sound decision-making.
- Excellent communication and stakeholder management.
- Ability to work under tight deadlines and pressure
3. KNOWLEDGE & EXPERIENCE
- 5+ years’ experience in life claim’s function, with 2+ years in a supervisory or lead role
- Strong knowledge of retail life products and systems
4. QUALIFICATIONS
- Bachelor’s degree in Commerce or a related field.
- Professional certification (e.g., AIIK, ACII, ALMI) preferred