Senior Life Policy Claims Specialist

🏗 We're Hiring: Senior Life Policy Claims Specialist

Location: United Arab Emirates (Remote)

Employment Type: Full-Time

Experience Level: Senior-Level

Work Arrangement: Fully Remote

About Us

We are a UAE-based insurance organization committed to delivering reliable, transparent, and customer-focused life insurance services. Our team works to ensure that policyholders and beneficiaries receive accurate, timely, and fair claims decisions while maintaining compliance with applicable UAE insurance regulations, contractual obligations, and industry best practices.

We are seeking an experienced Senior Life Policy Claims Specialist to oversee complex life insurance claims, strengthen claims assessment procedures, and support consistent, compliant, and compassionate claims management.

The Role

The Senior Life Policy Claims Specialist will manage complex life insurance claims from initial notification through assessment, decision-making, settlement, and closure. This role requires strong knowledge of life insurance policy provisions, beneficiary entitlements, underwriting considerations, fraud indicators, and regulatory requirements.

The successful candidate will collaborate with underwriting, legal, compliance, actuarial, customer service, and external medical or investigative professionals to ensure claims are handled fairly, efficiently, and in accordance with policy terms and applicable UAE requirements.

Key Responsibilities

• Review, assess, and adjudicate complex life insurance claims, including death, terminal illness, critical illness, and other covered benefit claims.
• Verify policy validity, coverage periods, premium payment status, exclusions, waiting periods, and applicable benefit limits.
• Examine policy contracts, endorsements, application forms, medical records, death certificates, beneficiary documentation, and supporting evidence.
• Determine beneficiary eligibility and verify beneficiary designations, ownership rights, and supporting legal documents.
• Assess claims involving pre-existing conditions, material nondisclosure, misrepresentation, policy reinstatement, and contestability provisions.
• Investigate discrepancies, unusual claim patterns, potential fraud, and suspicious circumstances in coordination with authorized internal teams and external specialists.
• Apply policy provisions consistently and document the rationale for approvals, partial settlements, requests for additional evidence, and claim denials.
• Coordinate with medical professionals, hospitals, attending physicians, legal representatives, and relevant authorities when additional information is required.
• Manage complex, high-value, disputed, and escalated claims in accordance with delegated authority limits.
• Ensure claims decisions and settlement procedures comply with applicable UAE insurance legislation, regulatory requirements, data protection obligations, and internal policies.
• Calculate claim benefits, applicable deductions, outstanding premiums, policy loans, surrender values, and other contractual adjustments where relevant.
• Coordinate approved claim payments with finance and payment operations teams, ensuring accurate beneficiary details and appropriate authorization.
• Communicate professionally and empathetically with beneficiaries, policyholders, brokers, and authorized representatives throughout the claims process.
• Prepare clear explanations for claims decisions, evidence requirements, and settlement calculations while maintaining confidentiality.
• Manage complaints, reconsideration requests, and disputed claims, escalating legal or regulatory concerns when necessary.
• Maintain accurate digital claim files, decision records, correspondence, and audit trails within claims management systems.
• Monitor claims inventories, aging reports, service-level agreements, and outstanding documentation to prevent avoidable delays.
• Identify recurring claims issues and recommend improvements to claims procedures, fraud controls, quality assurance, and customer experience.
• Support internal audits, regulatory reviews, management reporting, and periodic reviews of claims policies and procedures.
• Mentor junior claims assessors, review complex cases, and contribute to technical training and knowledge-sharing initiatives.

Qualifications and Experience

• Bachelor's degree in Insurance, Finance, Business Administration, Law, Risk Management, or a related discipline.
• Typically 5–8 years of experience in life insurance claims assessment, adjudication, policy administration, or related insurance operations.
• Demonstrated experience managing complex life insurance claims, including death and living-benefit claims.
• Strong understanding of life insurance policy structures, beneficiary rights, exclusions, contestability, underwriting disclosures, and claims settlement calculations.
• Knowledge of applicable UAE insurance laws, regulatory expectations, and relevant Central Bank of the UAE requirements, as applicable to the organization and its licensed activities.
• Familiarity with claims governance, anti-fraud controls, customer complaint handling, and internal audit requirements.
• Experience interpreting medical evidence and coordinating with medical or legal professionals when assessing claims.
• Proficiency in claims management platforms, policy administration systems, Microsoft Excel, and digital document management tools.
• Strong analytical, investigative, documentation, and decision-making skills.
• Excellent written and verbal communication skills, with the ability to explain sensitive decisions clearly and empathetically.
• High standards of integrity, confidentiality, impartiality, and professional judgment.
• Relevant professional insurance qualifications, such as those offered by the Chartered Insurance Institute (CII), are advantageous.
• Experience working with remote teams and managing confidential digital workflows is preferred.

Key Performance Indicators (KPIs)

• Claims Turnaround Time: Complete assessments and decisions within established service-level agreements.
• Claims Decision Accuracy: Maintain high accuracy and consistency in coverage assessments and settlement calculations.
• Regulatory Compliance: Meet applicable regulatory, contractual, and internal control requirements.
• Documentation Quality: Maintain complete, accurate, and audit-ready claim records.
• Customer Experience: Deliver clear, timely, and empathetic communications to claimants and beneficiaries.
• Fraud Detection Effectiveness: Identify and appropriately escalate suspicious claims and material inconsistencies.
• Claims Backlog Management: Reduce overdue claims and minimize unnecessary processing delays.
• Settlement Accuracy: Ensure approved benefits and payments are calculated and processed correctly.
• Complaint Resolution: Resolve or escalate disputed claims within defined timelines.
• Process Improvement: Contribute measurable improvements to claims efficiency, quality assurance, and operational controls.
• Team Development: Support the technical development and performance of junior claims personnel.

What We Offer

• Competitive salary based on qualifications, experience, and technical expertise.
• Fully remote working arrangement, subject to business, regulatory, and information-security requirements.
• Opportunity to manage complex claims and contribute to improvements in claims governance.
• Professional development and support for relevant insurance qualifications.
• Collaborative working relationships across claims, underwriting, legal, compliance, and finance teams.
• Access to digital claims management tools and structured operational processes.
• A professional environment that values fairness, accountability, confidentiality, and customer care.
• Opportunities for career progression into claims leadership, claims governance, or insurance operations management.

How to Apply

If you have substantial experience in life insurance claims and a strong commitment to fair, accurate, and compliant claims decisions, we invite you to apply.

Please submit your updated CV and a cover letter outlining your life claims experience, technical expertise, and relevant professional qualifications.

Email Subject Line: “Senior Life Policy Claims Specialist – UAE Remote”

Shortlisted candidates will be contacted for an interview and further assessment. Please ensure that your application highlights your experience with complex claims, beneficiary verification, claims investigations, and applicable UAE insurance requirements.