Claims Specialist

1 month ago

Markham, Canada TD Bank Full time

409006BR

Insurance

Markham, ON

Calgary, AB Edmonton, AB Halifax, NS

August 4, 2023

Hours

35

Pay Details

Department Overview

TD Insurance is part of TD Bank Group, one of Canada’s largest financial institutions. TD Insurance helps protect clients from the ‘accidents of life’ with a wide range of products including credit protection, life, health, travel, home and auto insurance. With more than three million clients, TD Insurance authorized products and services are available online, over the phone, and through a network of more than 1,000 TD Canada Trust branches.
In Canada, we have two lines of business, General Insurance and Life and Health. Our General Insurance business is one of the top home and auto insurance groups in Canada and the national leader in group insurance and affinity marketing. Our Life and Health business is the number one provider of critical illness insurance and direct life and health insurance in Canada.
- At TD Insurance, we are committed to fostering an inclusive, accessible environment. With a Canada-wide workforce of over 4,000 employees and offices in Atlantic Canada, Quebec, Ontario and Alberta, our company is always growing and can help you to grow. TD Insurance offers a stable and dynamic work environment where talent is appreciated and professional development is taken seriously. More than just a job, we offer rewarding careers.

Job Details

The Complex Claims Advisor is responsible for the investigation, evaluation and timely resolution of complex claims which may involve litigation and environmental issues within their area of expertise and authority. Uses expert knowledge to handle complex, high risk claims that typically take in excess of 1 year to resolve. Maybe required to meet clients/witness etc. to obtain statement and/or negotiate claims, as well as attend legal proceedings on behalf of TDI. This role contributes to the legendary customer experience by collaborating with internal and external partners while valuing speed and accuracy. The Complex Claims Advisor applies their technical knowledge to ensure all claims are appropriately reserved and resolved while mitigating risks and escalations.
** KEY ACCOUNTABILITIES**

***
**CUSTOMER**
- Use expert knowledge to handle complex, high risk claims that typically take over a year to resolve.
- Maybe required to meet clients/witness etc. in the field to obtain statements and/or negotiate claims
- Collaborate with internal and external partners while valuing speed and accuracy to deliver the legendary customer experience
- Identify potential fraudulent claims and handle according to organizational processes/procedures
- Work with claim management vendors to maintain service standards

**SHAREHOLDER**
- Support the timely and accurate completion of business processes and procedures
- Protect the interests of the organization - identify and manage risks, and escalate non-standard, high risk transactions / activities as necessary
- Ensure documentation that is prepared/completed is accurate and properly reflects client / business intentions and is consistent with relevant rules/regulations
- Identify, suggest and actively participate in process improvement opportunities
- Actively manage relationships within and across various business lines/ corporate and/or control functions and ensure alignment with enterprise and/or regulatory requirements
- Ensure necessary due diligence to support the accuracy of all customer transactions / activities
- Keep abreast of emerging issues, trends, and evolving regulatory requirements and assess potential impacts
- Maintain a culture of risk management and control, supported by effective processes in alignment with risk appetite
- Assume responsibility to minimize operational and regulatory risk by complying with Bank and industry Code of Conduct

**EMPLOYEE / TEAM**
- Participate fully as a member of the team, support a positive work environment that promotes service to the business, quality, innovation and teamwork and ensure timely communication of issues/ points of interest
- Provide thought leadership and/ or industry knowledge for own area of expertise in own area and participate in knowledge transfer within the team and business unit
- Keep current on emerging trends/developments and grow knowledge of the business, related tools and techniques
- Participate in personal performance management and development activities, including cross training within own team
- Keep others informed and up-to-date about the status/progress of projects and / or all relevant or useful information related to day-to-day activities
- Contribute to team development of skills and capabilities through mentorship of others, by sharing knowledge and experiences and leveraging best practices.
- Lead, motivate and develop relationships with internal and external business partners / stakeholders to develop productive working relationships.
- Contribute to a fair, positive and equitable environment

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