Senior Insurance Claims Specialist

Job Title: Senior Insurance Claims Specialist Location: UAE Employment Type: Full-Time Work Arrangement: On-Site / Hybrid, depending on business requirements Level: Senior About Us We are seeking an experienced Senior Insurance Claims Specialist to manage complex insurance claims, assess policy coverage, coordinate claim investigations, and ensure accurate and timely claim settlements. The successful candidate will work closely with policyholders, brokers, insurers, loss adjusters, legal representatives, and internal departments to deliver efficient claims services while maintaining compliance with applicable UAE insurance regulations and company policies. Key Responsibilities Manage the end-to-end claims process, from initial notification and registration through investigation, assessment, approval, settlement, and closure. Review insurance policies, coverage terms, exclusions, endorsements, and supporting documents to determine claim eligibility. Assess complex claims involving property, motor, medical, liability, engineering, or other insurance products, depending on business requirements. Investigate claim circumstances, evaluate supporting evidence, and identify inconsistencies, potential fraud indicators, or coverage concerns. Coordinate with loss adjusters, surveyors, medical reviewers, repairers, legal advisors, and other external service providers. Verify claim documentation, invoices, estimates, medical reports, police reports, incident records, and other relevant evidence. Calculate claim liabilities, settlement amounts, deductibles, depreciation, policy limits, and applicable excesses in accordance with policy terms. Recommend claim approvals, partial settlements, repudiations, or escalations based on documented findings and delegated authority. Negotiate settlements with claimants, brokers, service providers, and other stakeholders while protecting the organization's financial interests. Monitor outstanding claims, reserve adequacy, settlement timelines, recoveries, and potential exposure to large or complex losses. Identify suspected fraudulent claims and escalate concerns in accordance with established investigation and reporting procedures. Coordinate recovery and subrogation activities, including pursuing responsible third parties where appropriate. Support reinsurance notifications, claim submissions, and recovery documentation for eligible claims. Maintain complete claim files, accurate system records, decision rationales, and audit-ready documentation. Ensure claims are handled in accordance with applicable UAE insurance regulations, internal procedures, service standards, and customer protection requirements. Respond to escalated customer complaints and resolve disputes professionally and within established timelines. Prepare claims reports covering settlement trends, outstanding liabilities, loss ratios, processing efficiency, and operational risks. Identify opportunities to improve claims workflows, strengthen controls, reduce processing errors, and enhance customer experience. Provide technical guidance and support to junior claims staff and contribute to team training and knowledge sharing. Qualifications and Experience Bachelor's degree in Insurance, Finance, Business Administration, Risk Management, Law, or a related discipline. At least 5–8 years of experience in insurance claims management, claims assessment, insurance operations, or loss adjustment. Strong understanding of insurance policy wording, coverage assessment, exclusions, deductibles, claims procedures, and settlement practices. Experience handling complex claims, reviewing supporting evidence, assessing financial exposure, and preparing settlement recommendations. Familiarity with applicable UAE insurance regulations and relevant Insurance Authority functions now administered by the Central Bank of the UAE, where applicable. Knowledge of claims fraud indicators, investigation procedures, subrogation, recovery processes, and reinsurance claims handling. Experience using claims management systems, policy administration platforms, and electronic document management tools. Strong analytical, numerical, investigative, and problem-solving skills. Excellent negotiation, communication, and stakeholder management abilities. Ability to interpret policy terms accurately and make fair, evidence-based decisions. High attention to detail and the ability to manage multiple claims and competing deadlines. Proficiency in Microsoft Office, particularly Excel, and familiarity with claims reporting tools. Relevant insurance qualifications, such as CII certifications or equivalent professional credentials, are an advantage. Strong commitment to customer service, confidentiality, ethical conduct, and regulatory compliance. Key Performance Indicators (KPIs) Claims Turnaround Time: Process and resolve claims within agreed service-level timelines. Settlement Accuracy: Ensure claim assessments and settlement calculations are accurate and consistent with policy terms. Claims Quality: Maintain complete documentation and evidence-based claim decisions. Customer Satisfaction: Improve customer experience and reduce avoidable complaints. Fraud Detection: Identify and appropriately escalate suspicious claims and potential irregularities. Reserve Accuracy: Maintain appropriate estimates of outstanding claim liabilities. Recovery Performance: Support timely and effective subrogation and reinsurance recoveries. Compliance: Ensure adherence to regulatory requirements, internal controls, and claims handling procedures. Operational Efficiency: Reduce processing delays, rework, and unresolved claims backlogs. What We Offer Competitive compensation based on qualifications and experience. Opportunities to manage complex claims and develop specialized insurance expertise. Professional development and support for relevant insurance qualifications. Collaboration with experienced insurance, legal, risk, and operational professionals. Opportunities for career advancement within claims management and insurance operations. A professional, customer-focused working environment that values fairness, accountability, and continuous improvement. How to Apply Interested candidates should submit an updated CV and a brief cover letter highlighting their insurance claims experience, policy interpretation skills, investigation expertise, and achievements in improving settlement accuracy or claims processing efficiency. Email Subject Line: Application – Senior Insurance Claims Specialist (UAE) We welcome analytical and customer-focused professionals with strong claims expertise, sound judgment, and a commitment to delivering fair, accurate, and compliant insurance claims outcomes. 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