Claims Investigator
1 week ago
As a Claims Investigator - Special Investigations Unit, you will be responsible for investigating complex property & casualty insurance claims with elements of potential fraud, misrepresentation, and/or exaggeration, for all lines of business.
Key Responsibilities:
- Evaluate concerns & fraud indicators to develop investigative plans for all lines of business in insurance claims (Property, Auto Fire & Theft, Cargo, Casualty, Accident Benefits), and Claims with Legal disputes
- Serve as resource for Claims operation for special investigations & fraud
- Consult with Claims business units, provide resources & recommendations to assist fraud initiatives
- Communicate with stakeholders, prepare reports, trial briefs & updates on investigations in timely & respectful manner
- Build & maintain business relationships with law enforcement (police, fire, border control), government bodies, and investigative organizations
- Attend court proceedings or hearings
- Ensure ongoing handling of claims investigations within company standards, industry best practices & regulations
- Assist with ongoing training of internal anti-fraud personnel
- Provide feedback to Management on process & system improvement initiatives
- Comply with relevant provincial & federal laws, Insurance regulations, carrier best practices, follow & enforce Echelon Claims policies, procedures, & best practices
- Assist with evaluating, selecting, ensuring quality and cost containment for vendors including defense firms, private investigators, records review companies, legal document & photocopy companies, expert witness and other vendors that might be 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 drivers license and use of a personal vehicle
- Litigation experience, legal & 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 & timely analysis of trends
- Ability to work in teams & independently
What's In It For You:
- 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
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