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AIA Group

Pan-Asian life insurance provider

Claims Consultant

Claims AdjudicationConfirmed live in the last 24 hours
Full-timeHong KongNo salary listedIn-person

About the Job

Requirements

  • A bachelor's degree or above in Insurance, Business Administration, Healthcare, or a related discipline is required.
  • At least 6–8 years of relevant claims experience, including solid exposure to High Net Worth or complex claims handling, is required.
  • Strong technical claims expertise is required, including the ability to manage complex cases, handle complaints, and deliver fair and well-reasoned adjudication outcomes.
  • A good understanding of regulatory and compliance requirements, such as Anti-Money Laundering, the Foreign Account Tax Compliance Act, and the Common Reporting Standard, and experience in governance-related activities are required.
  • Experience handling escalations and complaint cases is required, including assessing reputational and regulatory risks and managing stakeholder communications effectively.
  • Experience supporting product development or reviewing policy terms is required, including identifying claims implications and operational considerations.
  • Strong analytical, problem-solving, and decision-making skills, attention to detail, and sound judgment are required.
  • The candidate must be able to communicate and manage stakeholders effectively with distribution channels, internal teams, and external parties.
  • The candidate must demonstrate ownership, accountability, and the ability to work independently and contribute to a team and project environment.

Responsibilities

  • Manage end-to-end processing of High Net Worth claims, ensuring accurate, consistent, and timely adjudication in line with policy terms and internal guidelines.
  • Maintain quality control and cost management, optimizing claim outcomes while upholding customer-centric service standards.
  • Provide proactive, clear, and empathetic communication to distribution channels throughout the claims lifecycle.
  • Collaborate with the Transaction Hub, Underwriting, and other internal stakeholders to ensure seamless claims handling and service delivery.
  • Manage and resolve claims-related customer complaints, ensuring fair, balanced, and well-reasoned outcomes aligned with policy terms and regulatory requirements.
  • Handle complex and escalated cases, including cases with potential reputational, regulatory, or channel impact, such as media, IA, or ICB-related cases.
  • Communicate clearly and empathetically with customers and stakeholders throughout complaint resolution.
  • Conduct root cause analysis on complaint cases, identify systemic issues, and recommend process or guideline enhancements to prevent recurrence.
  • Collaborate with Legal, Compliance, Channels, and other internal stakeholders to ensure consistent and defensible complaint handling.
  • Serve as the Claims Subject Matter Expert for regulatory and compliance initiatives, including the Foreign Account Tax Compliance Act, the Common Reporting Standard, and Anti-Money Laundering, ensuring adherence to internal policies and external requirements.
  • Coordinate and manage alerts from IFPCD, taking timely action to detect, investigate, and mitigate potential fraudulent claims.
  • Review and enhance internal claims guidelines and deliver training to stakeholders to drive consistency, awareness, and compliance across teams.
  • Provide claims insights and technical input during product design and enhancement to ensure policy terms and benefit structures are clear, consistent, and operationally feasible.
  • Partner with Product, Underwriting, and Distribution teams to review product features, exclusions, and claims triggers, minimizing ambiguity and improving claims adjudication effectiveness.
  • Identify potential claims risk exposure, anti-selection, and cost implications, and recommend mitigation measures during product development.
  • Support post-launch reviews by sharing claims experience, emerging trends, and feedback to refine product design and improve customer outcomes.
  • Support the Team Head in executing business priorities, operational initiatives, and ad hoc assignments.
  • Coordinate with auditors, reinsurers, and cross-functional teams to ensure timely and accurate responses to governance and reporting requirements.
  • Participate in projects and transformation initiatives, contributing to process improvements, operational efficiency, and alignment with evolving business needs.

Desired Qualifications

  • Exposure to fraud detection and investigation processes is an advantage.
  • Professional qualifications such as FLMI, ALHC, or equivalent are preferred.

About the Company

AIA Group

Pan-Asian life insurance provider

AIA Group provides life insurance and related financial protection across Asia. It sells life insurance, protection, and long-term savings products to individuals and groups, paying benefits and claims when needed. It differentiates itself with a pan-Asian footprint across 18 markets, long-standing customer and agent relationships, and a strong focus on environmental, social, and governance practices. Its goal is to be a leader in ESG while helping millions live Healthier, Longer, Better Lives and creating long-term value for stakeholders.

Company size
10,001+
Company stage
Not listed
Total funding
$618.7M
Headquarters
Central and Western District, Hong Kong
Founded
Not listed

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