SIU Claims Manager

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.