Head of Claims

General Description: The Head of Claims is responsible for the strategic and effective management of the Claims function, encompassing Individual Insurance Claims, Group Life & Health Claims, and Pre-assessment teams. The incumbent leads the Claims function’s contribution to the Claims Transformation project by defining the Claims Target Operating Model, articulating future-state requirements, shaping end-to-end workflow design, driving change management, and ensuring alignment with business priorities, operational objectives, and customer experience outcomes. This position reports directly to the Chief Operations Officer, Hong Kong & Macau. Responsibilities: Claims Experience Delivery • Lead the Claims team’s participation in the Claims Transformation project by defining future-state processes and workflow requirements • Provide expert input on claims operations, digitization, Straight Through Processing, and assessment practices to shape the design of the Claims Target Operating Model • Partner with Operations Transformation, the Claims Product Owner, IT, and cross-functional teams to co-design solutions and system capabilities • Represent Claims in system development and testing to ensure functionality, data accuracy, and operational usability • Drive change management, team readiness, and adoption of new processes and technologies • Define and monitor key metrics and drive continuous improvement initiatives Claims Risk Management • Work with the Claims Risk Manager and Chief Medical Officer to implement a customer-centric, business-value-driven Claims Assessment Philosophy aligned with the company’s risk appetite, while safeguarding reputation and profitability • Work with the Claims Risk Manager and Chief Medical Officer to ensure the company’s claims practices remain market competitive • Ensure consistency and integrity in claims assessment approaches and decisions across the team • Ensure compliance with corporate and regulatory guidelines • Ensure claims audits are completed in accordance with corporate requirements Pre-assessment Management • Oversee the Pre-assessment team to deliver timely, consistent support to distribution channels, customers, and internal stakeholders • Ensure pre-assessment practices align with claims philosophy, product provisions, underwriting considerations, and corporate guidelines • Monitor service quality, turnaround time, and case consistency to support effective claims experience delivery Distribution Channel Management • Maintain effective two-way relationships with distribution channels to gather market feedback on claims practices, processes, and service support • Train and guide distribution channels to understand and support the company’s claims philosophy New Product Development/Claims Initiatives • Ensure smooth rollout of product and claims initiatives in alignment with corporate policies and guidelines • Collaborate with relevant stakeholders to develop claims assessment practices for new products and claims initiatives • Ensure effective and timely training of claims assessors for new or revised guidelines Team Development • Build a high-performing team and develop a sustainable succession plan • Demonstrate leadership capability to develop an engaged, client-centric team that delivers sustainable business, operational, employee, and customer outcomes • Strengthen talent development, performance management, and team effectiveness to support business continuity and succession objectives Accountabilities (Individual / Shared): Individual Accountabilities: • Claims Performance Management and Operations • Claims Risk Management • Customer and Claims Experience • Team Leadership and Talent Development Key Shared Accountabilities: • Claims Transformation and Digital Enablement • Claims Experience Delivery • New Product Development and Claims Initiatives • Distribution Channel Management • Customer Experience and Complaint Management • Business Continuity and Operational Resilience Knowledge/Skills/Competencies/Education: • Degree in Insurance, Finance, Business Administration or a related field • At least 15 years of claims experience, including leadership experience in life insurance claims • Proven experience in claims operations management, performance management, governance, and regulatory compliance • Experience in process improvement, automation, digital transformation, and claims operating model design • Transformation-ready leadership skills • Customer-centric mindset with sound commercial judgment and risk awareness • Proven leadership capability in talent development, succession planning, coaching, and team engagement • Effective stakeholder management skills across distribution, product, underwriting, medical, actuarial, legal, compliance, IT, vendors, and external partners • Change management capability to lead teams through transformation and embed new ways of working • Effective communication, influencing, problem-solving, and decision-making skills Problems/Challenges: • Balancing customer experience, claims risk, regulatory expectations, and commercial outcomes • Maintaining BAU service quality while leading transformation readiness • Driving consistent claims assessment across teams, products, and locations • Manage a two-way relationship with all Distribution Channels Position Dimensions (Organizational Impact): • Oversees a team of 40+ employees in Hong Kong, plus an offshore team of approximately 40 employees in Chengdu • Distribution channels managed include agency, banks, and brokers, including approximately 11,000 agents When you join our team: • We’ll empower you to learn and grow the career you want. • We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words. • As part of our global team, we’ll support you in shaping the future you want to see. This Position Description is intended to describe the general nature and