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Claims Investigator SIU

2 months ago

Mississauga, Ontario, Canada CAA Club Group Full time

Job Summary

We are seeking a highly skilled Claims Investigator to join our Special Investigations Unit (SIU) team at CAA Club Group. As a Claims Investigator, you will be responsible for investigating complex property and casualty insurance claims with elements of potential fraud, misrepresentation, and/or exaggeration.

Key Responsibilities

  • Evaluate concerns and fraud indicators to develop investigative plans for all lines of business in insurance claims, including property, auto, fire, and theft, cargo, casualty, accident benefits, and claims with legal disputes.
  • Serve as a resource for Claims operations for special investigations and fraud.
  • Consult with Claims business units, provide resources and recommendations to assist fraud initiatives.
  • Communicate with stakeholders, prepare reports, trial briefs, and updates on investigations in a timely and respectful manner.
  • Build and maintain business relationships with law enforcement, government bodies, and investigative organizations.
  • Attend court proceedings or hearings.
  • Ensure ongoing handling of claims investigations within company standards, industry best practices, and regulations.
  • Assist with ongoing training of internal anti-fraud personnel.
  • Provide feedback to Management on process and system improvement initiatives.
  • Comply with relevant provincial and federal laws, insurance regulations, carrier best practices, follow and enforce Echelon Claims policies, procedures, and best practices.
  • Assist with evaluating, selecting, ensuring quality and cost containment for vendors, including defense firms, private investigators, records review companies, legal document and photocopy companies, expert witnesses, and other vendors used for settlement of auto claims.

Requirements

  • Post-secondary education in Criminology, Insurance Management, Business Administration, or industry experience.
  • CIP designation completed or in progress preferred.
  • 5+ years' experience in Property and Casualty insurance industry.
  • 2+ years as SIU investigator.
  • Must have a valid driver's license and use of a personal vehicle.
  • Litigation experience, legal and SIU regulations knowledge.
  • Clear understanding of insurance industry practices, standards, and terminology.
  • Experience handling property damage, injury claims, serious injuries, and litigation.
  • Strong passion for the P&C insurance industry with focus on fraud containment.
  • Strong technical, analytical, problem-solving, and ability to exercise prudent judgment to make decisions based on accurate and timely analysis of trends.
  • Ability to work in teams and independently.

What We Offer

  • Competitive total compensation and benefits package.
  • Annual shared success program based on performance.
  • Annual merit increases based on performance.
  • Defined Contribution Pension Plan with a matching contribution component.
  • Complimentary CAA Membership.