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Job Title: SIU Claims Manager
Reporting to: Head of Claims Performance
Location: London
Position Type: Permanent, 35 hours per week
Why Tokio Marine HCC?
Standing still is not an option in the current world of Insurance. TMHCC are one of the world’s leading Specialty Insurers. With deep expertise in our chosen lines of business, our unparalleled track record and a solid balance sheet, TMHCC evaluates and manages risk like no one else in the industry. Looking beyond profit, empowering our people and delivering on our commitments are at the core of our customer values, and so is a desire to grow and provide creative and innovative solutions to our clients.
Job Purpose:
The Claims Fraud Investigation Manager leads the identification, investigation, prevention, and mitigation of fraudulent insurance claims. The role is responsible for developing fraud detection strategies, ensuring regulatory compliance, minimising financial losses, and supporting a culture of fraud awareness across the organisation.
The postholder will work closely with Claims, Underwriting, Legal, Compliance, Data Analytics, and external stakeholders to protect the business from fraudulent activity and maintain fair outcomes for genuine customers.
Key Responsibilities:
Lead and manage complex and high-value claims fraud investigations from referral through to resolution.
Oversee the assessment, triage, and allocation of suspected fraud cases.
Ensure investigations are conducted professionally, ethically, and in accordance with legal and regulatory requirements.
Review evidence, investigation reports, surveillance findings, and intelligence sources to support decision-making.
Determine appropriate case outcomes, including claim repudiation, civil recovery, prosecution referrals, or settlement recommendations.
Contribute to the development and implementation of the organisation's fraud prevention strategy.
Identify emerging fraud trends, risks, and vulnerabilities across claims operations.
Recommend process improvements and fraud controls to reduce exposure.
Support the implementation of fraud detection technologies, analytics, and intelligence-led investigations.
Build strong partnerships with Claims, Underwriting, Legal, Compliance, Risk, and Underwriting teams.
Represent the organisation in external forums, industry groups, and regulatory discussions where required.
Liaise with external investigators, solicitors, police, insurers, and fraud intelligence networks.
Ensure all investigative activities comply with applicable legislation, FCA requirements, data protection regulations, and company policies.
Maintain accurate case records and investigation documentation.
Support internal and external audits relating to fraud management activities.
Produce management information and reporting on fraud performance, trends, and outcomes.
Monitor fraud detection rates, investigation outcomes, and financial savings.
Ensure service level agreements and operational targets are achieved.
Drive continuous improvement initiatives to enhance fraud capability and efficiency.
Skills and Experience Specification:
Essential:
Significant experience in insurance claims fraud investigation, financial crime, or fraud risk management.
Strong understanding of insurance claims processes and fraud typologies.
Experience handling complex, organised, and high-value fraud investigations.
Knowledge of relevant legal, regulatory, and data protection requirements.
Excellent analytical and investigative skills.
Strong stakeholder management and influencing capabilities.
Experience using fraud detection systems, intelligence platforms, and analytical tools.
Strong report writing and presentation skills.
Desirable:
Experience within a Special Investigations Unit (SIU).
Experience collaborating with law enforcement agencies.
Professional accreditation in fraud investigation or financial crime.
What We Offer
The Tokio Marine HCC Group of Companies offers a competitive salary and employee benefit package. We are a successful, dynamic organization experiencing rapid growth and are seeking energetic and confident individuals to join our team of professionals.
The Tokio Marine HCC Group of companies is an equal opportunity employer. Please visit www.tmhcc.com for more information about our companies.
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