Senior Claims Investigator

The Senior Claims Investigator contributes to Wawanesa’s goal of delivering an exceptional and consistent claims service experience through the thorough investigation of highly complex referred files and to fraud prevention initiatives.

Job Responsibilities

• Provide exceptional customer service.
• Review referred claim files to determine the type and scope of investigation required.
• Investigate possible causes of loss via examination of forensic evidence and collection, preservation and submission of evidence to police agencies and or courts.
• Take charge of investigations for cases of a suspect of fraudulent nature.
• Pursue police charges for prosecution, prepare Crown Briefs and provide evidence.
• Understand the application of policy language as it is applied to coverage, liability and settlement of claims.
• Maintain strict confidentiality and ensure compliance with Privacy Regulations.
• Provide ongoing updates on the status of investigations.
• Compose investigation reports and advise claims staff and management of findings and further recommended action.
• Maintain accurate records based on company standards and policies within the claims system.
• Conduct ad hoc internal claims audits.
• Attend court proceedings as required.
• Remain up-to-date with case law, legal tactics, fraud trends and other information that may help limit losses or improve the effectiveness of the detection system.
• Attend loss locations in the field and conduct on-scene investigations.
• Perform other duties as assigned.