Claims Field Siu Specialist
3 months ago
**We're now at the boldest phase of our Next Horizon journey**
At Gore Mutual, we've completely transformed our business in under three years. By investing in top talent and leading technology, we've redefined what it means to be a modern mutual that does good.
Our path forward brings a sharper focus on our business' performance that's powered by innovation and an agile, high-performing culture - we're built for success.
**We're well on our way to becoming a purpose-driven, digitally led national insurer. Come join us.**
As a Field SIU Specialist, you will be given a company car to ensure that you're 'boots on the ground' to conduct on-site investigations of claims, collecting statements, and gathering various forms of evidence.
**What you will do**:
- Investigate to determine if there is evidence of fraud by clients, third party claimants, suppliers (body shops, medical treatment providers, etc).
- Conduct on-site investigations and obtain in person statements.
- Review submitted documents for inconsistencies/other signs of fraud.
- Compose final reports and recommendations to our Claims department for disposition of file.
- Assist in the design and delivery of regular, customized fraud detection, investigation, and avoidance training for the various specialized lines of claims handlers & underwriters.
- Attend Examinations under oath where required and oversee claims in litigation.
- Provide mentoring and coaching to junior team members.
- Regularly attend industry training, CASIU events, and others to maintain proficiency and ensure Gore is aware of the latest trends in Insurance Fraud. Prepare and deliver education sessions to highlight trends and promote fraud awareness among different stakeholders such as underwriting & claims teams and external broker partners.
**What you will need**:
- 10+ years of investigative insurance experience.
- 5+ years of training/mentorship experience.
- Previous experience with Claims Guidewire considered an asset.
- Property, Auto, Accident Benefit & Casualty claims investigation experience.
- CIP, CFEI, or CFE designations completed or in progress.
- Secondary school completion is a requirement.
- Familiarity with anti-fraud technology in detection of potential fraud
Ind-HP
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