Proactively engage and maintain effective relationships with Underwriting, Actuarial, Finance, Legal, Compliance, Risk, Internal Audit, Sales, Customer Service, Technology and Product teams, to uphold seamless claims operations.
Oversee the end-to-end notification, registration, validation, investigation, assessment, approval, repudiation and settlement of claims across individual and group life portfolios.
Ensure claims are handled within approved turnaround times, policy terms, delegated authorities and applicable legal and regulatory requirements.
Oversee complex, contentious, litigated and ex gratia claims, escalating material matters appropriately and documenting the rationale for decisions.
Ensure clear, timely and empathetic communication with claimants, beneficiaries, policyholders, intermediaries and corporate clients, particularly in sensitive situations (e.g. bereavement).
Maintain effective complaint resolution and escalation processes, conduct root cause analysis and translate insights into service improvements.
Uphold and own continuous improvement through claims process redesign, automation, workflow discipline and effective case management, to enhance customer experience and minimize risk exposure.
Ensure compliance with applicable NAICOM, regulations, regulatory guidelines, anti-money laundering requirements, data protection obligations and internal policies.
Maintain robust claims policies, standard operating procedures, decision records, quality assurance reviews and audit trails.
Uphold preventive and detective controls minimize claims leakage, fraud, error, duplicate payments and unauthorised settlements.
Actively coordinate claims investigations and coordinate with Compliance, Legal, Internal Audit, law enforcement and external specialists, where required.
Ensure timely and accurate regulatory, statutory and management reporting (monthly/quarterly, etc), on outstanding claims, ageing, repudiations, complaints, recoveries and material exposures.
Promptly address audit, compliance and regulatory findings and ensure agreed remedial actions are sustained.
Sustain a high performing claims team with clear objectives, appropriate capacity, strong technical capability and disciplined performance management.
Qualifications
Minimum of first degree or equivalence (e.g. B.Sc.) in Insurance, Actuarial, or related courses
Must possess a recognized professional qualification/certification in Insurance (e.g. CIIN or CII) and minimum membership of Associate (ACIIN or ACII)
Experience
Minimum of 10 years of progressive operational experience in life insurance administration, policy processing, or actuarial/claims management.
Minimum of five (5) years’ experience (post-professional qualification) in the technical department of an insurance institution.
Demonstrable experience overseeing complex and high value claims, claims governance, fraud risk, litigation, reserving interfaces and reinsurance recoveries.
Strong practical knowledge of the Nigerian life insurance market and the legal and regulatory environment governing claims administration.
Key Competencies
Claims Expertise: Deep and practical knowledge of life claims assessment, policy interpretation, medical and financial evidence, investigation and settlement.
Regulatory and Risk Judgement: Applies sound judgement within legal, regulatory, ethical and risk parameters.
Customer Centricity: Balances compassionate service with disciplined policy and control requirements.
Commercial and Financial Acumen: Understands the impact of claims on profitability, reserves, capital, reinsurance and customer value.
Data-led Decision-Making: Converts claims data into actionable insight and measurable interventions.
Strategic Team Coordination: Sets direction, translates strategy into execution and drives sustainable change.
People Management: Builds capability, accountability and collaboration
Communication and Influence: Communicates complex and sensitive decisions clearly and credibly to diverse stakeholders.
Integrity and Courage: Makes fair, evidence-based decisions and constructively challenges inappropriate outcomes.
Operational Excellence: Establishes disciplined processes, effective controls and a continuous-improvement culture
Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.
