Senior Claims SIU Investigator

Zurich Insurance CompanyToronto, ON, CA

30+ days ago

Salary

CAD250000 yearly

Job description

The Opportunity

Are you looking for a caring, collaborative, values-driven workplace with inspiring teammates and leaders? Do you have the ambition and desire to be the best and thrive at the most impactful global insurance provider in the world? Look no further than Zurich Canada.

If you have experience in professional investigations involving financial crimes, or insurance claims investigation with a law enforcement agency, and are looking for a new challenge, we would love to hear from you.

Zurich Canada is currently looking for a Senior Claims SIU (Special Investigations Unit) Investigator.

Reporting to the Investigative and Recovery Services Manager, you will direct, lead and conduct investigations of suspect fraud, high exposure, and complex investigations within an assigned geographic region / Line of Business (LOB). Suspect premium fraud cases may also be included in the type of cases worked. Cases may also include claimant, third party vendor, and or Agent (Broker) matters. Receives limited to moderate technical direction and works within broad limits and authority on highly complex assignments to ensure that all claims fraud risks are effectively and efficiently governed and managed.

This is a unique opportunity to build your knowledge and experience for the future in a supportive environment where your voice matters.

This is a hybrid work opportunity.

What you will do

Conducts complex, sensitive, or high exposure investigations within assigned geography or Line Of Business in the local Business Unit, or outside normal geography / Line Of Business, as required.
Researches information and database searches, prepares surveillance assignment, assigns to vendor and reviews results with subsequent documentation.
Leads investigative team on the resolution of highly complex, sensitive, and / or suspect organized ring cases within geography.
Investigates all aspects of highly complex claims referred for investigation, including circumstances of loss, background of individuals / businesses and underwriting aspects.
Participates in department and Business Unit initiatives as directed.
Gathers information from various sources and interviews witnesses.
Maintains impeccable documentation, back up and files to support all aspects of the case.
Prepares and provides investigative reports to Claims, Management, Business Partners, Business Units and other required stakeholders.
Acquire and efficiently organise the relevant evidence and information necessary to accurately assess whether or not there is a fraudulent aspect to individual claims or fraud ring / network claims.
Collaborate with external agencies to secure information and data which is relevant to individual investigations.
Conduct desk and field investigations including face to face interviews with customers, witnesses and other persons relevant to the investigation, obtaining formal written statements.
Adheres to local regulation and Zurich Claims governance requirements throughout the investigative process to ensure that all information and data is obtained within data protection rules and regulations.
Liaises closely with senior managers and claim handlers throughout the investigative process and ensuring that all stakeholders are immediately aware of any important issues that are identified.
Identify promptly cases which need to be further escalated.

Additional responsibilities :

Serves as primary subject matter expert for the development of technical training and team member coaching.

Job Qualifications - What you bring to the table

Required :

Bachelor's Degree and 7 or more years of experience in the professional investigations involving other financial crimes or Insurance claims investigation with a law enforcement agency area

High School Diploma or Equivalent and 9 or more years of experience in the professional investigations involving other financial crimes or Insurance claims investigation with a law enforcement agency area

Preferred :

Bachelor's Degree and 9 or more years of experience in multi-line commercial claims handling

Bachelors Degree and 7 or more years of experience in SIU insurance claims handling

In depth knowledge of claims process

In depth knowledge of regulations and statutes in the assigned territory

Microsoft Office skills

Our Culture

At Zurich, we are proud of our culture. We are passionate about Diversity, Inclusion, Equity and Belonging (DIEB). We want you to bring your whole self to work, and we want our employees to be reflective of the communities in which we live and work. Our DIEB initiatives are creating an environment where everyone feels welcome.

We have a collaborative culture where diversity of thought is valued. We value your input and strive to give our employees the tools they need to make an impact.

We care about our employees’ well-being and offer a comprehensive health / benefits plan with varying levels of coverage to suit your specific needs and a competitive total compensation package.

We understand how important it is to rest, recharge and do the things you love. At Zurich, all employees receive a minimum of four weeks of vacation per year to do just that.

We also understand that employees require time off for personal reasons. Maybe you have an appointment during a workday, a cultural or religious holiday you would like to observe, or you need time off to focus on your mental health. Zurich employees receive four personal days per year to be used at their discretion.

We are committed to continuous improvement, and offer access to a comprehensive range of training and development opportunities.

We care about our communities. Our communities are where our customers, people, and shareholders live and work. While we can be proud of the contribution to society Zurich makes through our core business of insurance, we must also give back to our communities through our talent, time and resources.

We have won numerous awards for our workplace culture. We are proud to be one of Greater Toronto’s Top Employers and to have received Insurance Business Canada’s 5-Star Diversity, Equity and Inclusion Award.

Make a difference. Be challenged. Be inspired. Be supported. Love what you do. Work for us.

About Us

A future with Zurich

Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 148 years of experience managing risk and supporting resilience. We are a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. Today, we serve more than 25 industries, from agriculture to technology and insure 90% of the Fortune 500®. Our growth strategy is not limited to our business. As an employer, Zurich strives to provide ongoing career development opportunities and foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our people, our customers and the communities we serve.