Senior Life Policy Claims Specialist

Job Title: Senior Life Policy Claims SpecialistLocation: UAE (Remote) Employment Type: Full-Time Level: Senior Work Arrangement: Fully Remote — 100% Work From Home

About Us
We are committed to delivering accurate, fair, and timely life insurance claims services while maintaining high standards of customer care, regulatory compliance, and operational integrity. We are seeking an experienced Senior Life Policy Claims Specialist to manage complex life insurance claims, verify policy benefits, investigate claim circumstances, and ensure decisions are consistent with policy terms and applicable requirements. The ideal candidate will possess strong claims assessment skills, sound analytical judgment, and the ability to handle sensitive cases with professionalism and confidentiality in a fully remote environment.

Key Responsibilities
• Review, assess, and process life insurance claims in accordance with policy provisions, contractual obligations, internal procedures, and applicable regulations.
• Manage complex and escalated claims involving death benefits, terminal illness, critical illness, disability, and other covered benefits, as applicable to the policy portfolio.
• Verify policy status, coverage eligibility, premiums, beneficiaries, sum assured, exclusions, waiting periods, and applicable benefit conditions.
• Examine claim forms, death certificates, medical reports, policy documents, beneficiary records, and other supporting evidence.
• Conduct detailed reviews of claims requiring additional verification, including discrepancies in documentation, beneficiary information, or policy history.
• Coordinate with medical professionals, hospitals, beneficiaries, legal representatives, agents, underwriting teams, and external investigators when necessary.
• Assess policy terms, exclusions, contestability provisions, and relevant contractual conditions before recommending claim approval, rejection, or further investigation.
• Identify potential misrepresentation, suspicious circumstances, fraudulent documentation, and inconsistencies requiring escalation.
• Ensure claim decisions are supported by adequate evidence, documented reasoning, and appropriate authorization.
• Investigate disputed claims, appeals, complaints, and requests for reconsideration in accordance with established procedures.
• Communicate claim requirements, decisions, outstanding documentation, and settlement updates clearly and professionally to beneficiaries and relevant stakeholders.
• Coordinate with finance and payment teams to facilitate accurate and timely settlement of approved claims.
• Monitor pending claims, investigation timelines, outstanding documents, and cases approaching service-level deadlines.
• Maintain complete, accurate, and auditable electronic records of claims assessments, communications, decisions, and settlements.
• Protect sensitive personal, financial, medical, and beneficiary information in accordance with applicable confidentiality and data protection requirements.
• Support internal audits, quality assurance reviews, regulatory examinations, and claims governance initiatives.
• Analyze claims trends, rejection reasons, processing delays, and recurring documentation issues to identify opportunities for improvement.
• Provide technical guidance to junior claims specialists on policy interpretation, complex assessments, documentation standards, and escalation procedures.
• Collaborate with underwriting, actuarial, compliance, legal, customer service, and risk management teams to resolve complex cases.
• Perform all responsibilities remotely while maintaining productivity, secure information handling, and effective communication with distributed teams. Qualifications and Experience
• Bachelor's degree or diploma in Insurance, Finance, Business Administration, Risk Management, Law, or a related field.
• At least 5–8 years of relevant experience in life insurance claims, policy benefits assessment, insurance operations, or claims investigation.
• Demonstrated experience handling complex, high-value, disputed, or escalated life insurance claims.
• Strong understanding of life insurance products, policy conditions, beneficiary entitlements, exclusions, and claims settlement procedures.
• Experience reviewing medical documentation, death certificates, policy records, and supporting evidence.
• Knowledge of claim investigation practices, fraud indicators, misrepresentation issues, and appropriate escalation procedures.
• Familiarity with UAE insurance practices and relevant regulatory requirements is an advantage.
• Ability to interpret policy wording accurately and apply contractual provisions consistently.
• Excellent analytical, investigative, problem-solving, and decision-making skills.
• Strong written and verbal communication skills, particularly when explaining sensitive or complex claim decisions.
• High attention to detail and the ability to manage multiple claims while meeting service-level requirements.
• Proficiency in Microsoft Office and familiarity with claims management platforms, policy administration systems, and electronic document management tools.
• Strong ethical standards and the ability to handle confidential and emotionally sensitive matters with discretion and empathy.
• Ability to work independently in a fully remote environment and collaborate effectively with cross-functional teams.
• Relevant professional qualifications in life insurance, claims management, or insurance administration are an advantage. Key Performance Indicators (KPIs)
• Claims Processing Accuracy: Maintain high accuracy in policy interpretation, eligibility verification, benefit calculations, and claim decisions.
• Turnaround Time: Process claims and resolve escalated cases within established service-level agreements.
• Claims Quality: Minimize avoidable errors, incomplete assessments, and incorrect claim decisions.
• Settlement Efficiency: Facilitate timely and accurate payment of approved benefits.
• Investigation Effectiveness: Identify discrepancies and potential fraud indicators and escalate concerns appropriately.
• Compliance: Maintain adherence to policy terms, internal procedures, and applicable regulatory requirements.
• Customer and Beneficiary

Experience:
Provide clear, empathetic, and timely communication throughout the claims process.
• Documentation Standards: Maintain complete, accurate, and auditable claims records.
• Appeals Resolution: Review disputed claims thoroughly and resolve cases within established timelines.
• Productivity: Meet agreed claims processing and case management targets without compromising decision quality.
• Continuous Improvement: Recommend improvements that enhance efficiency, consistency, and the overall claims experience.

What We Offer
• Competitive compensation based on qualifications and professional experience.
• 100% remote work arrangement, allowing you to work from home without routine office attendance.
• Opportunities to contribute to life insurance claims governance, operational improvement, and customer service excellence.
• A collaborative and professional working environment focused on integrity, accuracy, and accountability.
• Opportunities for career development in life insurance, claims management, and insurance operations.
• Access to digital collaboration tools and systems that support secure remote work.
• A performance-oriented culture that values professional judgment, confidentiality, empathy, and continuous improvement.

How to Apply
Interested candidates should submit an updated CV and a brief cover letter highlighting their life insurance claims experience, expertise in complex claims assessment, policy interpretation skills, investigation experience, and relevant professional achievements. Email Subject Line: Application – Senior Life Policy Claims Specialist (Fully Remote, UAE) We welcome experienced professionals who combine technical claims expertise, sound judgment, attention to detail, and a commitment to fair and compassionate claims handling.
• Important: This position is intended to be fully remote. Candidates should confirm applicable employment, residency, and work authorization requirements before accepting an offer.