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TD Insurance is part of TD Bank Group, one of Canada's largest financial institutions. TD Insurance helps protect clients from the 'accidents of life' with a wide range of products including credit protection, life, health, travel, home and auto insurance. With more than three million clients, TD Insurance authorized products and services are available online, over the phone, and through a network of more than 1,000 TD Canada Trust branches.
In Canada, we have two lines of business, General Insurance and Life and Health. Our General Insurance business is one of the top home and auto insurance groups in Canada and the national leader in group insurance and affinity marketing. Our Life and Health business is the number one provider of critical illness insurance and direct life and health insurance in Canada.
At TD Insurance, we are committed to fostering an inclusive, accessible environment. With a Canada-wide workforce of over 4,000 employees and offices in Atlantic Canada, Quebec, Ontario and Alberta, our company is always growing and can help you to grow. TD Insurance offers a stable and dynamic work environment where talent is appreciated and professional development is taken seriously. More than just a job, we offer rewarding careers.
The SIU department provides investigative services, technical expertise, and is a resource for Claims Services nationally. The SIU department's vision is of world class performance and technical expertise dedicated to the appropriate investigation of insurance claims consistent with the highest standards of professional, ethical and legal conduct. The SIU department investigates files where there is a need for a more in-depth and specialized investigation beyond the scope of Claims Services. Where fact-finding is required, an SIU investigation is conducted in a fair, objective, thorough, timely and professional manner, enabling TDI to objectively make a determination of the facts and circumstances, appropriately addressing fraudulent and non-meritorious matters, and facilitating the resolution of meritorious claims. Job Description
Investigative Advisors are accountable for conducting thorough investigation for suspicious claims assigned to them. They gather evidence (with the assistance of SIU Investigators) and are responsible for the claims handling of matters accepted for investigation by the Group Managers, Fraud. They investigate claims for fraud or policy violations and deny or resolve claims as appropriate. They may also recommend the reporting of activity to the appropriate authorities. Investigative Advisors handle all aspects of claims adjusting including: initial claim handling, customer contact, making payments when appropriate, dealing with customer complaints as well as claim disposition and resolution where appropriate.
The position is office-based with a limited ability to work from home. Requirements KEY ACCOUNTABILITIES
• Complete thorough investigations while being sensitive to and protecting TDI's culture of client service
• Determine investigation strategy using a combination of inside investigation and cognitive interviews, supported by Investigators (field investigators) as needed
• Manage routine claim handling activities, including reserving, payments, claim resolution and closure, and work in partnership with other TDI groups (e.g., subrogation, underwriting)
• Prepare investigation reports and formulate conclusions using consequence matrix; share conclusions and recommendations with Group Manager, Fraud
• Consult Group Managers, Fraud, on consequence management and follow escalation procedures for nuanced cases
• Use internal advanced analytics tools to detect, identify, investigate and prevent fraud.
• Notify customers of outcome of investigation and, where appropriate, resolve claims.JOB REQUIREMENTS
- 5+ years of claims handling experience ideally in multiple lines of business (Auto PD, Residential, Bodily Injury and Accident Benefits). Consideration will also be given to those with significant expertise in one line of business based on the department's needs.
- A demonstrated commitment to fraud investigation through previous SIU referrals/involvement.
- Knowledge of legal processes and evidence collection.
- Guidewire Claimcenter experience is mandatory
- Minimum college-level working proficiency.
- Fully bilingual French/English
• Ability to work in advanced analytics systems including data mining programs
• Precision and attention to detail
• Practiced in active listening and summarizing evidence and analytical assessments in order to provide solid and supportable conclusions/actions
• Ability to properly delegate investigative tasks to Investigators for optimal use of resources
• Expert knowledge of Insurance products, systems, policies and procedures and Insurance Act and associated legislation
• Superior knowledge of the principles of casualty, accident benefit, residential and/or automobile physical damage insurance, and associated claims adjustment processes/procedures
• Sustained achievement in claims handling and compliance, evidenced by excellent Claims Performance scores
• Ability to professionally and tactfully handle difficult conversations and confrontation
• Enrolment in the CIP program and completion of the Principles & Practices course is an assetCROSS-FUNCTIONAL RELATIONSHIPS
Advanced Analytics Team
Fraud Oversight & Governance
Business Operations Control
Claims Operations Personnel and Management
Claims Performance Team
Fraud Control & Fraud Management Group
Global Security & Investigations
Legal Services, Claims Litigation Services, External Legal Counsel
VendorsKNOWLEDGE AND SKILLS
Emotional Intelligence Expert
Impact and Influence Expert
Continuous Improvement Process Mgmt./Improvement Expert
Time Management/ Planning & Organizing Balance Stakeholder Needs Expert
Communicating with external entities such as law enforcement, IBC, Collision Reporting Centres Knowledgeable
Provincial licensing required
Post-secondary education or equivalent work experienceAdditional Information
At TD, we are committed to fostering an inclusive, accessible environment, where all employees and customers feel valued, respected and supported. We are dedicated to building a workforce that reflects the diversity of our customers and communities in which we live and serve. If you require an accommodation for the recruitment/interview process (including alternate formats of materials, or accessible meeting rooms or other accommodation), please let us know and we will work with you to meet your needs.