SIU Claims Manager

Posted 22 Days Ago
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London, Greater London, England, GBR
In-Office
Senior level
Insurance
The Role
Lead and manage complex insurance fraud investigations across claims lifecycle. Develop detection strategies, liaise with stakeholders and external partners, ensure legal/regulatory compliance, implement analytics and fraud controls, report on trends and outcomes, and drive continuous improvement in fraud capability.
Summary Generated by Built In

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.

#LI-NW1

Skills Required

  • 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 (including FCA 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.
  • Experience within a Special Investigations Unit (SIU).
  • Experience collaborating with law enforcement agencies.
  • Professional accreditation in fraud investigation or financial crime.

Tokio Marine Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Tokio Marine and has not been reviewed or approved by Tokio Marine.

  • Healthcare Strength Medical options include established carriers with PPO and HDHP choices, plus dental, vision, pharmacy, telehealth, and condition‑specific programs for comprehensive access. An employee assistance program and mental‑wellbeing resources further reinforce day‑to‑day support.
  • Retirement Support A 401(k) with company match and employer‑paid life and disability coverage strengthen long‑term financial security. Careers materials and recent updates signal continued attention to retirement and protection benefits.
  • Wellbeing & Lifestyle Benefits Wellness incentives, fitness access, and a holistic “body, mind, wallet, life” framework expand total‑rewards value beyond insurance alone. Paid volunteer time and community programs add lifestyle‑oriented benefits aligned with purpose.

Tokio Marine Insights

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The Company
Houston, Texas
2,600 Employees

What We Do

Tokio Marine HCC can help you or your clients be prepared for unpredictable weather patterns. Event weather insurance protects revenue losses caused by adverse weather conditions that reduce attendance and the sales of concessions, food and parking.

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