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Senior Claims Consultant

Date: Jun 12, 2021

Location: Toronto, CA

Company: SCOR

     Americas     

Toronto Canada (CA) 

|

Senior Claims Consultant 

Permanent 

Claims 

 

 

          About SCOR         

SCOR, the 4th largest reinsurer in the world, provides insurance companies with a diversified and innovative range of solutions and services to control and manage risk. Using its experience and expertise, “The Art & Science of Risk”, SCOR provides cutting-edge financial solutions, analytics tools and services in all areas related to risk – in Life & Health insurance as well as in P&C insurance. Our specialist teams operate in over 120 countries, developing value added and innovative products and services and making long-term commitments to their clients, namely insurers and large corporations.
SCOR's aim, as an independent global reinsurance company, is to develop its Life and P&C business lines, to provide its clients with a broad range of innovative reinsurance solutions and to pursue an underwriting policy founded on profitability, supported by effective risk management and a prudent investment policy, in order to offer its clients an optimum level of security, to create value for its shareholders, and to contribute to the welfare and resilience of Society by helping to protect insureds against the risks they face.

 

Job Summary

 

We are seeking a Senior Claims Consultant to join our team. The role would involve close collaboration with our clients, and your focus will be on providing claim reviews and recommendations to clients on claims management strategies.

 

You would work locally as part of a global team, collaborating with and learning from claims colleagues in our other markets. The ideal candidate would have a passion for change management and fostering relationships.

 

The Senior Claims Consultant promotes SCOR Global Life’s image and expertise in a wide variety of Group and Individual life & health insurance products, including life, disability and critical illness.  The role involves a wide range of responsibilities including the following:

 

 

Key duties and responsibilities

 

Claims Adjudication & Relationship Management

  • Analyze medical, financial and contractual information in order to make timely and accurate decisions on claims
  • Provide value-added claims adjudication expertise on Life, CI, DI, LTD and accidental death claims
  • Provide advice to clients concerning contentious claims, claim practices, policy rescissions and benefit/policy interpretation
  • Establish target response time and ensure that objectives are met
  • Support other business units with timely communication of issues, escalations or points of interest
  • Remain current on industry practices, emerging trends and developments
  • Participate in the development of Claims management procedures and guidelines within SCOR Global Life Canada
  • Provide advice to underwriting management concerning claims experience in the industry pertaining to underwriting matters, pricing, policy exclusions and insurance applications

 

Audits & Training

  • Assist in the performance of claims audits for all lines of business
  • Participate in client meetings and provide training either virtually or in-person; travel to client offices may be required
  • Contribute to the development of training programs for clients

 

Other:

  • Review and establishment of claim referral guidelines
  • Provide input into decisions regarding new tools, processes and technology upgrades
  • Project management and data analysis
  • Respond to special requests from clients and resolve complex issues
  • Support marketing efforts of the Business Development team by maintaining positive relationships with clients
  • Enhance and maintain internal litigated claim management and record keeping practices to minimize risk exposure, contain costs and realize optimal resolutions
  • Represent the company at industry events as an attendee and/or presenter
  • Participation on industry committees
  •  

Required experience & competencies:

 

Experience:

  • 7 or more years of insurance/reinsurance claims adjudication experience in Life, CI, and DI
  • In-depth knowledge of life and health insurance industry, products and services
  • Strong decision-making, negotiation and leadership skills
  • Experience with client/industry presentations
  • Exceptional interpersonal and customer service skills
  • Excellent verbal and written communication skills
  • Project management and data analytics experience an asset
  • Bilingual in French and English preferred

 

Education:

  • Bachelor’s degree or equivalent
  • Relevant industry designations such as FLMI, ALHC

 

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