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 level of the work being performed by employees in this job. It is not intended to be a complete list of all responsibilities, duties and skills required for this job classification.

宏利金融有限公司是全球领先的金融服务提供商，致力于帮助大众轻松作出明智抉择，实现精彩人生。如欲了解更多关于我们的信息，请访问人寿保险-养老保险-健康保险-中宏保险官网 (manulife-sinochem.com).

宏利是平等機會僱主

在宏利／恒康，我們擁抱多元。我們致力於吸引、培養及挽留和所服務客戶同樣多元的員工，並從而營造包容的工作環境，接納文化和個體差異。我們矢志維持公平的招聘、挽留、晉升及薪酬制度，我們管理的所有實踐及項目不會因種族、血統、原籍地、膚色、族裔、國籍、宗教或宗教信仰、信仰、性別（包括懷孕及其相關情況）、性取向、遺傳特徵、退伍軍人身份、性別認同、性別表達、年齡、婚姻狀況、家庭狀況、殘疾或受適用法律保護的任何其他因素而區別對待。

我們的首要任務是消除障礙，為員工提供平等就業機會。人力資源部代表將盡力為應徵過程中提出要求的申請人提供合理協助。申請人要求提供協助所分享的信息將會按照適用法律及宏利／恒康政策儲存及使用。應徵過程中如需協助，請聯絡 hr@manulife.com。

Working Arrangement

混合办公