Claims Investigator, Investigative Services

Select how often (in days) to receive an alert: 137316 The Opportunity Are you looking for a caring, collaborative, values-driven workplace with inspiring teammates and leaders? Do you have the ambition and desire to be the best and thrive at the most impactful global insurance provider in the world? Look no further than Zurich Canada. If you have experience in claims investigations, law enforcement, or insurance special investigations and are looking for a new challenge, we would love to hear from you. Zurich Canada is currently looking for a Claims Investigator, for our Waterloo office,to support the identification, investigation, and mitigation of insurance fraud risks across an assigned geographic region. Reporting to the Claims Fraud and Investigations Manager, you will conduct investigations of suspected insurance fraud and complex claims matters while delivering high-quality investigative reports, evidence-based recommendations, and technically sound conclusions. As part of your responsibilities, 15-30% of your day will be spent reviewing investigative referrals, triaging them, and assigning them to the appropriate investigator. You will work closely with claims professionals, business partners, and leadership to ensure fraud risks are effectively identified, investigated, and managed in accordance with regulatory requirements and Zurich Claims governance standards. This is a unique opportunity to build your knowledge and experience for the future in a supportive environment where your voice matters. This posting is for an existing vacancy. Zurich Canada uses artificial intelligence-enabled tools to support certain aspects of the recruitment process, including the initial review and screening of applications. Artificial intelligence is not the sole basis for candidate shortlisting or selection. All hiring decisions are reviewed and made by qualified hiring professionals. Zurich follows a hybrid work model requiring three days per week of in-person presence, which may include time in the office or market-facing engagements. The position is currently based in Waterloo, with plans to relocate to our new Kitchener office when it opens in early 2027. What you will do
- Promptly review and triage investigative referrals from all sources
- Promptly assign investigations to the appropriate internal investigator after triaging them
- Provide counter fraud education on key fraud indicators, fraud trends, fraud metrics, etc. to Zurich adjusters and management
- Conduct fraud investigations within an assigned geographic region or line of business and support investigations outside your primary area when required.
- Investigate all aspects of referred claims, including circumstances of loss, claimant backgrounds, business operations, and underwriting considerations.
- Conduct research and database inquiries to support investigations and identify fraud indicators.
- Prepare surveillance assignments, coordinate with external vendors, and evaluate investigative findings.
- Gather information from a variety of sources and conduct interviews with claimants, witnesses, and other relevant parties.
- Secure recorded and signed statements and maintain thorough documentation of all investigative activities.
- Assess evidence and investigative findings to determine potential fraudulent activity.
- Collect and preserve evidence that may be required for arbitration, litigation, or criminal prosecution.
- Prepare comprehensive investigative reports containing findings, conclusions, and recommendations for Claims, management, business partners, and external agencies.
- Support the identification and investigation of organized fraud activity and fraud networks.
- Collaborate with claims handlers and senior leaders throughout the investigative process and communicate significant findings promptly.
- Escalate cases requiring additional expertise or senior-level review.
- Ensure all investigations comply with applicable legal, regulatory, privacy, and Zurich governance requirements. Job Qualifications
- What you bring to the table
- Bachelor's Degree and 4 or more years of experience in Technical Claims Investigations, Law Enforcement, or Insurance Special Investigations.
- OR
- Zurich Certified Insurance Apprentice, including an Associate Degree, and 4 or more years of experience in Technical Claims Investigations, Law Enforcement, or Insurance Special Investigations.
- OR
- High School Diploma or equivalent and 6 or more years of experience in Technical Claims Investigations, Law Enforcement, or Insurance Special Investigations.
- AND
- Knowledge of regulations and statutes pertaining to claims law.
- Knowledge of claims handling processes.
- Microsoft Office experience.
- Strong written and verbal communication skills.
- Strong organizational and prioritization skills.
- High attention to detail.
- Strong analytical and investigative skills. Our Culture
- At Zurich, we are proud of our culture. We are passionate