Retail Claims Officer

About the role

The Retail Claims Officer is responsible for the efficient processing and administration of individual life insurance claims, ensuring they are accurately assessed, properly documented and settled within established timelines. The role covers reviewing submissions, validating documentation and policy coverage, resolving claims issues with stakeholders and keeping accurate claims records in line with internal policies and regulatory requirements.

Key responsibilities

• Process and administer individual life insurance claims, including terminations, partial withdrawals, maturities and death claims.
• Review claims documentation and ensure all required information is complete before processing and payment.
• Prepare claim payment memoranda for management and Board approval within approved authority limits.
• Investigate claims and verify policy coverage to determine validity and entitlement before settlement.
• Prepare and maintain weekly, monthly and quarterly claims reports for management review.
• Maintain accurate claims records, including claim files, supporting documents and communication logs.
• Respond promptly to claim enquiries and guide customers through the claims process.
• Work with internal and external stakeholders to resolve claims issues and ensure timely settlement.
• Support internal control, audit and compliance activities by providing information and addressing audit queries.
• Support business retention and growth by remarketing customers after policy maturity or termination, identifying new business opportunities and taking part in Agency and Bancassurance sales meetings.

Required profile

• Bachelor's degree or HND in Insurance, Actuarial Science, Business Administration, Economics, Accounting, Finance or a related discipline.
• Professional insurance certification (ACIIN, ACII or equivalent) is an added advantage.
• 3 to 5 years of experience in insurance claims administration, customer service or insurance operations.
• Practical experience processing and assessing life insurance claims is an advantage.
• Good understanding of life insurance products, policy terms, conditions, exclusions and claims procedures.

Required skills

• Claims management policies and procedures
• Data collection and entry, with proficiency in Microsoft Excel
• Customer negotiation and problem-solving
• Report analysis and presentation
• Relationship management, attention to detail, time management and knowledge of regulatory and compliance requirements