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22 Nov 2022

Full-Time Senior Claims Specialist, Life, Critical Illness, A&D

Insurance Career Network – Posted by Monica Mississauga, Ontario, Canada

Job Description

Our client is an established 80+ year Canadian life, disability, and sickness insurer, and is one of the largest insurance companies for education workers in Canada. They are federally licensed and regulated to operate across Canada and have won awards for digital innovation. They provide Canadians affordable and instant insurance and healthy living benefits on an innovative and streamlined digital platform.

They are currently seeking a Senior Claim Specialist to help drive new and innovative solutions. Who is our ideal candidate? You want to build your career in the insurance industry and have experience adjudicating Life, Critical Illness, Accidental Death and Dismemberment, and Disability claims. You have excellent communication and organizational skills and can comfortably handle multiple priorities. You are comfortable working in a fast-paced, collaborative environment and actively look for ways to streamline processes and procedures.

Position Summary:

The Senior Claim Specialist will adjudicate Life, Critical Illness, Accidental Death & Dismemberment, and Long[1]Term Disability claims within established timeframes and within the scope of the policy, while ensuring excellent customer service. Their experience and vision will support process enhancement initiatives within the team and across the organization. The Senior Claim Specialist will be reporting directly to the Director, Underwriting and Risk.

Key Responsibilities:

Fully managing a caseload of new and ongoing Life, Critical Illness, Accidental Death & Dismemberment, and Long-Term Disability claims including recording new claim notifications and gathering information, through to assessment, rendering decision and payment of claim.

• Ensuring each claim is handled in a manner that is in accordance with approved procedures, confidentiality requirements, Privacy legislation, and Anti Money Laundering rules and regulations

• Proactively communicating with Claimants, Beneficiaries, Executors, legal representatives, and any appropriate stakeholders to keep them apprised of claim status updates and claim progression

• Engaging with reinsurers on claims decisions and administration

• Leading engagement with TPA partner on existing claim administration

• Proactively following-up on workflow requirements, escalating to leadership when needed

• Identifying, designing, and implementing process enhancements

• Developing process documentation and establishing SLAs for claims processing

• Proposing and building out departmental structure given expansion of business

• Providing training, coaching and ongoing mentorship to future staff as team grows

• Providing key information during internal and external audits, investigating any inconsistencies or issues that arise

• Engaging and collaborating with multiple lines of business to identify opportunities for improvement and business efficiencies

• Consistently providing exceptional service to internal and external customers by demonstrating the highest level of professionalism.

Qualifications and Experience:

• Bachelor’s degree or equivalent

• 7+ years’ experience adjudicating Life, Critical Illness, Accidental Death & Dismemberment, and Long[1]Term Disability claims

How to Apply

Insurance Career Network is a recruitment firm focused exclusively on the insurance industry.  Our relationships, knowledge and leading experience enable us to connect leading insurers, brokerage firm and independent adjusting firms with the most talented candidates for each role. Since 1991, we have been building and nurturing relationships and with over 13,000 registered candidates, we can tap into our highly technical experience for our clients.  Our recruiters come directly from insurance related positions and bring a wealth of knowledge to each recruitment assignment. TO APPLY: Register and submit your resume to  or call Monica for more information 416 703-5120 ext 201

Job Categories: Adjusting. Job Types: Full-Time.

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