Life & Health Claims Advisor Ii

1 month ago

Markham, Canada TD Bank Full time

**Work Location**:
Markham, Ontario, Canada

**Hours**:
37.5

**Line of Business**:
TD Insurance

**Pay Details**:
NA - NA CAD

TD Insurance is part of TD Bank Financial 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 5,000 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.

The Claims Department is responsible for adjudicating Life, Critical Illness, Accidental Death and Dismemberment, Disability and Hospital claims for the Bank’s Credit Protections programs and TD Life’s Direct Life and Health programs. Adjudication of these claims involves daily empathetic and professional communication with customers who are going through a personal crisis, either due to significant disability or death of a spouse or a family member. This department is responsible for evaluation of medical diagnoses’ and, the impact of disability on their ability to work at gainful employment.

**Job Description**:
Accountabilities include:

- Adjudicate claims promptly and effectively in a professional and empathetic manner.
- Approve legitimate claims within prescribed authority limits and Service Level Agreements
- Deny claims or rescind policies when required based on contractual definitions, limitations and exclusions
- Approve disability payments based on diagnosis, treatment, restrictions and limitations and occupationSound understanding of insurance concepts is required
- Job Requirements:

- This position requires a minimum Grade 12 education plus 5 years relevant insurance experience in either Individual or Group claims, or University degree or RN qualification. Through on-going professional development, the Claims Advisor is required to have the ALHC designation and actively work towards the FLMI, ALHC or FLHC designation.
- Solid working knowledge - Word, Excel
- Solid knowledge of TD Life products
- Superior interpersonal skills and ability to handle stressful situations with tact and courtesy
- Must be able to contribute to a positive working environment and have the ability to adapt effectively to a changing environment
- Utilize Change Management skills to promote and implement change positively and work as part of a team to accomplish the goals of our department

Additional Information:

- The ability to deliver legendary service by meeting or exceeding all service and quality objectives while effectively working with both external and internal partners to resolve claims and concerns in a thorough, precise and professional yet empathetic manner are vital for this position.
- Inclusiveness At TD, we are committed to fostering an inclusive, accessible environment,
where all employees and customers feel valued, respected and supported.
We are dedicated to building a workforce that reflects the diversity of our customers and communities in which we live and serve, and creating an environment where every employee has the opportunity to reach her/his goals.

**Who We Are**:
TD Securities offers a wide range of capital markets products and services to corporate, government, and institutional clients who choose us for our innovation, execution, and experience. With more than 6,500 professionals operating out of 40 cities across the globe, we help clients meet their needs today and prepare for tomorrow. Our services include underwriting and distributing new issues, providing trusted advice and industry-leading insight, extending access to global markets, and delivering integrated transaction banking solutions. In 2023, we acquired Cowen Inc., offering our clients access to a premier U.S. equities business and highly-diverse equity research franchise, while growing our strong, diversified investment bank. We are growth-oriented, people-focused, and community-minded. As a team, we work to deliver value for our clients every day.

**Our Total Rewards Package**
Our Total Rewards package reflects the investments we make

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