Company: CGIC
Department: Claims
Employment Type: Regular Full-Time
Work Model: Remote-Based
Language: English is required, French is an asset.
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 Claims team aspires to create peace of mind for our clients and our communities. Our national team of knowledgeable and trusted professionals serve our clients with compassion. We are passionate about continuous improvement and operate with high-integrity, motivated by our desire to do the right thing for our clients.
The Senior Investigator is responsible for the investigation and documentation of possible fraudulent activity received through various means including point of sale (application), underwriting, vendor and claims fraud on moderate to complex auto, property, injury and commercial claims. The Level of complexity and or value of assigned investigations and tasks typically is such that investigation in the field, dealing directly and face to face with relevant parties including clients, claimants, witnesses, vendors, law enforcement, regulatory enforcement, investigative personnel and collaboration with other insurer fraud teams is necessary to secure documentary and testimonial evidence and or effectively collaborate. The Senior Investigator will provide support and training to staff for the timely and appropriate resolution of claims investigations and loss prevention.
- Holistically review requests for investigation from various sources and identify necessary investigative activities. Work to ensure the timely and thorough investigation is completed.
- The Completion of a Safety Risk Assessment and subsequent Action Plan may be required to anticipate and prepare for potential risk when field work is required.
- In addition to noted preparation related to risk, assessing desilication of conflict and enhanced ability to manage situational personal safety events as required (i.e. in Field)
- Assess the complexity and value of cases, completing field task assignments as required.
- Collect, critically assess, and preserve evidence of internal and external business partners.
- Attend various loss locations to document the scenes and collect relevant evidence.
- Conduct investigations to ensure the authenticity of documents and evidence provided in substantiation of accurate policy coverage and/or claims.
- Fully document ongoing investigative results accordingly and participate in the policy or claim coverage decision-making process as required.
- Conduct investigations in accordance with all applicable provincial and federal legislation pertaining to the collection, use and disclosure of personal and corporate information.
- Assist with the development and delivery of training programs relating to fraud prevention and claims investigation.
- Participate in audits and file surveys to direct investigative resources to appropriate claims areas.
- Mentor, train, coach and counsel Claims Investigators to develop their ability in making sound assessments of investigative strategies, policy and law interpretations, and policy violations.
- Work with business partners, to coordinate the employment of forensic experts and provide directions to experts to ensure compliance with corporate service provider guidelines.
- Liaise with external representatives including Investigative Services Division of the IBC, Fire Marshalls Office, and law enforcement.
- Contribute to a client service culture by embedding client engagement philosophies into daily work and implementing innovative, client-centric decision making, to be the industry leader in client engagement.
- You have a Bachelors Degree.
- Completion of University degree or College diploma related to civil and criminal investigations preferred.
- Chartered Insurance Professional (CIP) or other insurance-related professional designation is preferred. Completion of or working towards CFE
- General knowledge of business operations tools (SalesForce, PolicyCentre, ClaimCentre, BillingCentre) is an asset.
- 3 years of experience in Specialized Discipline experience preferred; as well as investigations.
- Minimum of 5 years of insurance experience including supervisory level experience. Experience including Claims adjusting or significant risk evaluation for moral, morale and physical hazards, geared towards fraud and loss prevention is preferred; OR Minimum of 15 years prior employment in law enforcement, with experience in detailed criminal investigations and intelligence gathering
- Expertise in effective and appropriate methods of investigating suspected fraudulent acts and in the conduct of effective interviews.
- Working knowledge of personal computers and related software applications. i.e. Lotus Notes, Excel, Word and Internet.
- Excellent interpersonal and communication skills (verbal and written), often in difficult or stressful circumstances.
- Effective in managing sensitive/confidential data and information for purposes of analysis investigation and reporting.
- Effective in applying fraud analysis and investigative concepts to all entities within range of responsibility.
- Detailed understanding of insurance law and claim handling practices.
- You will be subject to a Background check as a condition of employment, in the event you are the successful candidate.
- Training and development opportunities to grow your career.
- Flexible work options and paid time off to support your personal and family needs.
- A holistic approach to your well-being, with physical and mental health programs and a supportive workplace culture.
- Paid volunteer days to give back to your community.
- In addition to our competitive salary and incentive programs, eligible employees also benefit from a comprehensive total rewards package including group retirement savings plans, pension and benefits (e.g., health and wellness, dental, disability and life coverage), mental health support and an employee assistance program.
Salary information
Expected salary/hourly range $72,847 - $121,411” (min-max, full range).
Salary placement
The salary amount for the successful candidate is determined by Co-operators in its discretion and will vary depending on several criteria including but not limited to: local market conditions, geography and relevant job-related factors such as knowledge, skills, qualification, experience and education.
Incentive/Variable pay
Employees may also have the opportunity to participate in incentive programs and earn additional compensation tied to individual and/or business performance, or other business metrics.
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