Claim Governance Lead - Hang Seng Insurance - Hang Seng Bank (HK)

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Insurance
Hang Seng Bank was one of Hong Kong's bancassurance pioneers with insurance business footprint started since 1965. Over the years, Hang Seng Bank has been committed to serve its customers by providing full spectrum of insurance products including Life Insurance manufacturing, distribution of General Insurance and Medical products, and MPF business.
Insurance is a fast-growing business and is one of the key drivers of Hang Seng Bank. As a well-established insurance entity, we take care of every need of our customers with an optimized service excellence through the Bank's retail and commercial network, with a dedicated team of professionals in place.

Principal responsibilities
1) Claims risk control & governance

• Ensure Claims compliance with governance standards in line with Group requirements (e.g., FIM) and applicable Hang Seng Bank / HSIC policies, including internal SOP control, reporting standards, and documentation expectations.
• Monitor and manage operational risk by applying the Group/Bank Compliance Policy, identifying claim-related operational risk themes, and proposing practical mitigations to reduce likelihood and risk impact.
• Produce and maintain governance MI and reporting (including ad hoc project / paper) for HSIC management oversight at EXCO, RMM, FLOD, Board, AC/RC and WMOC.
• Analyse claims trends and performance by reviewing monthly claims statistics, identifying emerging risks or exceptions, and escalating timely insights and recommendations to the Head of Claims. Assist to monitor claims process and claims decisions are adhered with company's guidelines and SLA
• Maintain and monitor the Claims QA process by completing monthly QA sample selection in accordance with the QA methodology, ensuring QA reviews are executed to the agreed standard and timeline, with clear proactive follow-up actions.
• Support claims related (ad hoc) projects and change managements by ensuring Risk Impact Assessments (RIA) and Materiality Assessment Papers (MAP) are completed on time, project milestones remain on track, and outcomes meet regulatory and internal governance requirements.

2) Claims customer care service

• Lead the Claims Services Ambassadors to proactively engage the potential major-claim customers (e.g., CI claimants and named beneficiaries for death claims) prior to claim submission to guide the customer, set customer expectations, reduce friction and enhance customer satisfaction over the whole claims journey.
• Improve and streamline the claims journey by driving enhancements, quick wins to claim forms, customer communications, claims process guideline, and claims brochures/content across all relevant touchpoints end-to-end.
• Track and act on customer feedback (including potential complaints), coordinating with relevant stakeholders to address root causes and implement service improvements.

3) People leadership & stakeholder management

• Lead, coach, and develop the team's capability, setting clear objectives, quality standards, and performance expectations.
• Partner with key stakeholders (Operations, Compliance, Risk, Audit, Product, Distribution, and Customer Experience) to deliver governance outcomes and customer improvements efficiently.

Requirements

• Minimum 10 years of Insurance experience
• Experience in handling claims complaints
• Good in written and spoken English and Chinese
• Strong self-motivation and ability to work under pressure
• Good communication and negotiation skills, with a thorough understanding of GL guidelines, AML and Local Industry Claims practice, company products with strong analytical mind
• Independent with strong job commitment and a Team player
• Great sense of ownership and servicing mindset to ensure efficient and effective customer service processes

RBW

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Hang Seng is committed to service excellence. Our people are our most important asset and play a vital role in our efforts to continually enhance our performance for customers and provide best-in-class products and services. We seek to attract high-calibre talent by offering a dynamic working environment, good career development opportunities and competitive compensation packages.

Issued by Hang Seng Bank Limited