Claims Officer

Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people’s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.

·Review claim notifications, supporting documents, and policy contracts.

Conduct investigations · Liaise with medical providers, hospitals, and funeral homes.

· Make recommendations or decisions on claim approvals, declines, or partial payments.

· Communicate claim requirements, decisions, and timelines clearly to claimants and beneficiaries.

· Provide updates to intermediaries, agents, and internal teams.

· Handle claim-related complaints and escalate unresolved issues.

· Ensure claims are processed in accordance with policy terms, company guidelines, and regulatory laws.

· Maintain accurate claim records and audit trails.

· Meet internal turnaround times (TATs) and service-level standards.

· Identify process gaps and propose improvements for efficiency and fraud prevention.

· Support data accuracy, claims analytics, and management reporting.

· Detect red flags for fraud and collaborate with internal fraud or legal teams.

· Ensure claims decisions mitigate financial, legal, and reputational risks.