About Us
CIC Insurance Group is a leading insurance and financial services organization with over five decades of experience supporting individuals, families, cooperatives, SMEs, and corporates to achieve financial security.
The Group offers a diversified portfolio spanning general insurance, life assurance, microinsurance, asset management, and investment solutions, with operations in Kenya, Uganda, South Sudan, and Malawi, and is listed on the Nairobi Securities Exchange.
Our tagline, “We Keep Our Word,” reflects our unwavering commitment to integrity, transparency, and delivering on our promises to clients, regulators, partners, and communities. CIC is committed to innovation, digital transformation, and prudent risk management to deliver sustainable value across its markets.
About the Role
Reporting to the Chief Executive Director, the Claims Manager – Life role will support the effective and efficient management of the life insurance claims function by ensuring accurate, timely, and fair assessment and settlement of claims; maintaining prudent and adequate reserving; ensuring full compliance with regulatory, policy, and governance requirements; and driving continuous improvement in claims processes, service delivery, and operational controls, while providing strong leadership, guidance, and professional development to the claims team.
PRIMARY RESPONSIBILITIES:
Claims Approval & Settlement
- Provide technical oversight and approval of life insurance claims discharge documentation within delegated authority levels.
- Authorize payment of life claims strictly in line with policy provisions, underwriting intent, reinsurance requirements, regulatory rules, and internal governance frameworks.
- Ensure all life claims are assessed, approved, and settled accurately, fairly, and within agreed turnaround times (TATs).
- Exercise sound judgment to ensure settlements reflect policy intent while safeguarding the company against financial, legal, and reputational risk.
- Review and validate complex claims assessments to ensure alignment with medical evidence, legal documentation, underwriting disclosures, and contractual obligations.
- Escalate high‑risk, high‑value, complex, or contentious claims with comprehensive analysis, risk assessment, and clearly articulated recommendations.
Claims Reserving & Review
- Establish, review, and adjust life claim reserves based on evolving claim facts, legal outcomes, and exposure assessments.
- Ensure reserves accurately reflect the ultimate liability and comply with actuarial input, accounting standards, and regulatory requirements.
- Monitor reserve adequacy and trends to minimise reserve volatility and financial misstatement.
- Conduct structured periodic reserve reviews, providing clear justification for material adjustments, strengthening overall portfolio transparency and control.
- Collaborate with actuarial and finance teams to enhance reserving accuracy and claims provisioning discipline.
Risk Management & Underwriting Support
- Analyse life claims experience, including mortality, morbidity, loss ratios, and emerging risk trends.
- Identify systemic issues, root causes, anti‑selection risks, and control gaps impacting portfolio performance.
- Provide targeted, data‑driven feedback to underwriting, pricing, and product teams to improve risk selection, pricing adequacy, and policy wording clarity.
- Support continuous enhancement of underwriting guidelines leveraging claims insights and lessons learned.
- Participate in post‑loss reviews, evaluations, investigations, and technical assessments.
Customer Service & Complaints Handling
- Champion fair and transparent claims handling in line with Treating Customers Fairly (TCF) principles.
- Manage escalated, sensitive, or complex claims complaints involving beneficiaries, policyholders, intermediaries, and regulators.
- Ensure professional, timely, and well‑documented communication at all stages of the claims journey.
- Build and maintain strong professional relationships with brokers, agents, reinsurers.
- Strengthen trust and brand reputation through balanced, customer‑centric, yet contractually sound decision‑making.
Regulatory, Governance & Management Reporting
- Prepare, validate, and submit accurate life claims returns and reports to the Insurance Regulatory Authority (IRA) within prescribed timelines.
- Ensure compliance with all statutory, regulatory, reinsurance, and internal reporting standards.
- Maintain high standards of data integrity, documentation quality, and audit readiness.
- Support internal, external, and regulatory audits by providing clear explanations, reconciliations, and corrective action plans.
- Produce insightful management reports highlighting claims performance, risk exposures, trends, operational efficiency, and emerging issues.
Appeals & Ex‑Gratia Claims Management
- Coordinate preparation and presentation of claim appeals and ex‑gratia requests to management, relevant or committees.
- Ensure all ex‑gratia settlements are justified, exceptional, fully documented, and aligned with approved governance frameworks.
- Track appeal outcomes and identify systemic lessons to enhance decision‑making consistency and reduce recurrence.
- Strengthen transparency and accountability in exceptional claims handling.
People Management & Development
- Provide strong leadership, supervision, and mentorship to life claims teams.
- Set performance standards aligned to quality, turnaround time, customer experience, and technical excellence.
- Conduct structured performance reviews and implement targeted development and succession plans.
- Allocate workloads effectively and monitor productivity to ensure service and quality benchmarks are consistently achieved.
- Foster a culture of professionalism, ethical conduct, accountability, collaboration, and continuous improvement.
Decision‑Making & Accountabilities
Financial Impact Decisions
- Approve life claim payments within delegated authority limits.
- Provide expert technical input into declined, disputed, negotiated, appealed, and ex‑gratia claims.
- Influence claims cost containment, reserve adequacy, loss ratios, and overall product profitability.
- Contribute to life claims budgeting, forecasting, and expense management initiatives.
Operational, Customer & People Impact Decisions
- Communicate claim decisions clearly, professionally, and sensitively to policyholders, beneficiaries, and intermediaries.
- Drive continuous improvement of life claims processes, controls, systems, and workflows.
- Coach and guide staff to enhance technical competence and decision quality.
- Ensure consistent adherence to service standards, ethical principles, regulatory requirements, and internal policies.
Who We’re Looking For
Academic & Professional Qualifications
- Bachelor’s degree in actuarial, Business Administration or a related discipline.
- Professional insurance qualification such as ACII, CII, Diploma in Insurance
- Master’s Degree in related field is an added advantage.
Experience
- Minimum of 8 years’ experience in claims Management.
Key Competencies
- Claims Technical Expertise – Strong knowledge of policy interpretation, claims assessment, settlement, and reserving practices.
- Analytical & Judgment Skills – Ability to analyse complex claims, assess risk and quantum, and make sound, fair decisions.
- Decision-Making & Accountability – Confident, timely decision-making within delegated authority with clear ownership of outcomes.
- Customer & Stakeholder Management – Professional handling of customers, intermediaries, complaints, and external service providers.
- Leadership & People Development – Ability to coach, mentor, and manage claims staff to achieve performance and quality standards.
- Planning & Time Management – Strong organization and prioritization skills to meet turnaround times and service levels.
- Communication & Reporting – Clear written and verbal communication, including regulatory and management reporting.
- Ethics, Compliance & Integrity – Commitment to ethical conduct, regulatory compliance, and Treating Customers Fairly principles.
Why Join Us
This role offers a unique opportunity to contribute to the performance and growth of a fast‑expanding insurance business.
As a Claims Manager, you will play a key role in ensuring efficient claims processing, improving service delivery, and strengthening customer confidence.
You will work closely with clients, intermediaries, service providers, and internal teams to deliver fair, timely, and accurate claims outcomes.
Your efforts will enhance the overall claims experience, support operational excellence, and drive continuous improvement.
The role provides a platform to champion best practices, optimize processes, and uphold strong governance across the claims function.
You will contribute to sustainable value creation for policyholders, partners, and the business.
This is an opportunity to make a meaningful impact while demonstrating professionalism, integrity, and exceptional service standards.
How to Apply
If you have the aforementioned professional and academic qualifications and you are ready to execute the above mandate, strictly apply through: https://careers.cicinsurancegroup.com/ clearly indicating the position being applied for.
The application should reach us by close of business on 25th May 2026. Please note only short-listed candidates will be contacted. If you do not hear from us by 15th June 2026 consider your application unsuccessful.
N/B: This job advert is open to both internal and external candidates.