Claims examiner Jobs in Hamilton, ON

Company : CUMIS

Department : Creditor Claims

Employment Type : Temporary Full-Time (12 months)

Work Model : Remote within GTA

Language : English is required, French is an asset.

The Opportunity :

We are a leading Canadian financial services co-operative committed to being a catalyst for a sustainable and resilient society and our team is essential to deliver on this strategy. That’s why we prioritize our people, to ensure we provide a strong culture and development opportunities which enables our team to thrive and to live our purpose. The best part is that you will work with people that care passionately about you, our clients, and our communities.

Our national Creditor team aspires to develop and deliver market leading products and solutions to exceed client expectations. We think strategically and collaboratively to create mutually beneficial results and achieve business objectives. We operate with high-integrity, motivated by our desire to do the right thing for our clients and their members.

The Claims Examiner III, Creditor Life and Disability adjudicates and manages a caseload of creditor Group Mortgage Protection (GMP) and Monthly Premium over $50,000 (MP) disability and life claims. This role is also responsible for adjudicating and managing claims for other creditor disability products including Loss of Employment (LOE), and where combined coverage exists, Single Premium (SP), Monthly Premium (MP) and Credit Card. This role assesses eligibility for disability and life benefits, develops case management plans, initiates, and implements interventions to minimize claim durations, authorizes and issues disability benefits.

How you will create impact :

• Through the review of current and historical medical information assess the initial insurance application to determine if a material misrepresentation (including fraudulent misrepresentation) has been made by the policyholder.
• For policies that are rescinded as a result of misrepresentation, communicate the decision to the appropriate parties including the policyholder.
• Ensure accuracy of, assess and review all information received in support of a new claim.
• Interview claimants, employers, loans officers by telephone prior to making claim decisions.
• Using the information received, the additional information gathered and the resources available and in accordance with policy provisions determine if the claim is payable.
• For each claim, develop and execute a proactive case management plan with the objective of minimizing the disability period.
• Initiate assessments and examinations where necessary.
• Proactively assess and review claims for change of definition including identifying alternative occupations and communicating change of definition decisions.

How you will succeed :

To join our team :

What’s in it for you?