Senior Claims Specialist

About FWD Group

FWD Group (1828.HK) is a pan-Asian life and health insurance business that serves approximately 40 million customers across 10 markets, including BRI Life in Indonesia. FWD’s customer-led and tech-enabled approach aims to deliver innovative propositions, easy-to-understand products and a simpler insurance experience. Established in 2013, the company operates in some of the fastest-growing insurance markets in the world with a vision of changing the way people feel about insurance. FWD Group is listed on the main board of the Hong Kong Stock Exchange under the stock code 1828.

For more information, please visit www.fwd.com

About FWD Life Philippines 

FWD Life Insurance Corporation (FWD Life Philippines) launched its commercial operations in September 2014. As of end-2022, FWD Life Philippines ranks 3rd and 6th in terms of Paid-up Capital(1) and New Business Annual Premium Equivalent(2), respectively.

For more information, please visit fwd.com.ph. 

1 www.insurance.gov.ph > Statistics > Life > 2022 > Based on Paid-Up Capital

2 www.insurance.gov.ph > Statistics > Life > 2022 > Based on New Business Annual Premium Equivalent

To ensure accurate, timely, and contract-based assessment of insurance claims—particularly complex and high-risk cases—by providing technical expertise, oversight, and decision support across the end-to-end claims journey.
The role supports the delivery of a positive customer experience by ensuring objective claim decisions, adherence to policy provisions, and effective cross-functional collaboration.

Service Functions:

• Perform detailed assessment of complex, high-value, or sensitive claims (e.g., contestability, non-disclosure, exclusions, medical complexity), ensuring decisions are aligned with policy provisions, underwriting disclosures, and regulatory standards.

• Manage assigned claim cases to ensure timely progression and adherence to target turnaround times (TATs) and internal service level agreements.

• Recommend claim outcomes and escalate cases requiring higher authority to the Claims Committee, Underwriting, Medical, Legal, or Finance, as appropriate.

• Support resolution of escalated cases or potential customer complaints by providing technical justifications and decision rationale to Claims Ambassadors for customer communication.

• Ensure proper application of non-forfeiture provisions, grace period rules, extensions, exclusions, and policy conditions, including assessment of exception cases subject to approval.

• Validate claim documentation, medical evidence, and investigative findings to ensure completeness, sufficiency, and audit readiness.

• Act as a subject-matter expert on policy interpretation, claims standards, and complex claims handling.

Documentation and Special Projects:

• Support onboarding and technical training of new Claims team members, including process orientation, policy fundamentals, and claims assessment standards.

• Provide guidance and technical coaching to Claims Ambassadors and Analysts to uplift claims quality and consistency.

• Participate in or co-lead claims-related projects and initiatives, including process improvements, risk controls, and efficiency enhancements.

• Assist in the preparation of administrative, operational, and statistical reports, including support for audits, management reporting, and regulatory submissions.

• Support User Acceptance Testing (UAT) and implementation of system enhancements, digital initiatives, or claims workflow changes.

• Perform other duties as assigned to support operational requirements and business continuity.

Privacy Notice

Your privacy is a priority for FWD.  The Company keeps your personal information with us in confidence. To know more about how we process your information, kindly refer to our FWD Recruitment Privacy Notice.

FWD has partnered with Talocity Instasolutions Private Limited (“Talocity”) to manage the initial filtering of candidate’s profiles through video interviews, social profile mapping, and video analytics using artificial intelligence engine that is offered within the Talocity platform.  The platform evaluates the candidate on the five well-known dimensions as per OCEAN Personality Model that influence occupational success and help understand workplace behavior. For more information, please refer to Talocity Privacy Policy.

When you apply, FWD will share your name, phone number and email address to Talocity to contact you and conduct the initial screening and profiling process.  Shortlisted candidates will then be contacted by FWD for the face-to-face interview. 

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