Claims Investigator

4 days ago


Mississauga, Ontario, Canada CAA Club Group Full time
Job Summary

We are seeking an experienced Claims Investigator to join our Special Investigations Unit (SIU) team at CAA Club Group. As a key member of our insurance fraud prevention team, you will be responsible for investigating complex property and casualty claims that exhibit potential fraud indicators.

About the Role

The ideal candidate will have a strong background in insurance investigations, with a focus on fraud detection and prevention. You will work closely with our claims operations team, law enforcement agencies, and other stakeholders to identify and investigate suspicious claims activity.

As a Claims Investigator, you will be responsible for:

  • Evaluating concerns and fraud indicators to develop investigative plans for all lines of business in insurance claims
  • Serving as a resource for claims operations on special investigations and fraud
  • Consulting with claims business units, providing resources and recommendations to assist fraud initiatives
  • Communicating with stakeholders, preparing reports, trial briefs, and updates on investigations in a timely and respectful manner
  • Building and maintaining business relationships with law enforcement agencies, government bodies, and investigative organizations
  • Attending court proceedings or hearings
  • Ensuring ongoing handling of claims investigations within company standards, industry best practices, and regulations
  • Assisting with ongoing training of internal anti-fraud personnel
  • Providing feedback to management on process and system improvement initiatives
  • Complying with relevant provincial and federal laws, insurance regulations, carrier best practices, follow and enforce Echelon Claims policies, procedures, and best practices
About You

To succeed in this role, you will need:

  • A 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
  • A valid driver's license and use of a personal vehicle
  • Litigation experience, legal and SIU regulations knowledge
  • A clear understanding of insurance industry practices, standards, and terminology
  • Experience handling property damage, injury claims, serious injuries, and litigation
  • A strong passion for the P&C insurance industry with a 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

We offer a competitive total compensation and benefits package, including:

  • 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
  • A salary range of $80,000 - $110,000 per year, depending on experience

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