Property Claims Investigative Advisor Moen
Aviva
Calgary
5d ago

Purpose

As accountability for fraud management is embedded in Aviva Canada’s National Claims Operation, the Investigative Property Advisor plays a critical role in developing the capabilities of Claims Advisors to be able to detect, investigate and determine the appropriate disposition of Property Fraud and other complex Property issues.

Additionally, as the first level escalation point for complex property claims, that are beyond the investigative capabilities of Claims Advisors, the Property Investigative Advisor uses a unique combination of skills to conduct stationary and task investigations to determine the validity of issues in question.

This unique skill set enables the timely resolution of the investigative issues to enable the Claim Advisor to simultaneously provide the customer with a seamless claim handling experience.

This role will also offer the opportunity to work from home for the right candidate.

Accountabilities

  • Be responsible for Claims Advisor Investigative Capability Development by Identifying where coaching and mentoring is required and provide constructive and positive feedback;
  • Provide guidance and assistance on investigative techniques to Claims Advisors and other claims staff;
  • Monitor fraud detection and investigation capabilities of Claims Advisors, and implement appropriate interventions where necessary to enhance fraud detection and investigation capabilities;
  • Provide ongoing technical expertise for claim fraud detection, investigation and disposition;
  • Develop and deliver learning interventions (e.g., huddles, workshops, one-on-one coaching, etc.), relating to investigation, fraud awareness, detection and prevention;
  • Evaluate accuracy of fraud identification by Claims Advisors;
  • Evaluate determination by Claims Advisors of the worthiness of conducting an investigation;
  • Prioritize investigations based on capacity and benefit to the company;
  • Identify cases that have deterrence value;
  • Determine which investigations are beyond the capabilities of Claims Advisors and require the investigative Property Advisor to act as Case Lead;
  • Participate in the development, ongoing evaluation and enhancements to investigative indicator technology;
  • Determine which cases are of the complexity to refer to the Central Fraud Management team for investigation and or task assignments;
  • Establish investigation strategy, gather and analyze facts, order appropriate searches, correctly utilize investigative vendors where required, conduct interviews through recorded statements, conduct EUO’s, manage case file, and ensure proper documentation and sufficient collection of physical evidence;
  • Partner with other Investigators as required;
  • Determine when an investigation is ready for disposition;
  • Prepare for and participate in Decision Panel meetings, as required;
  • Build a defendable case;
  • Manage customer relationship when dealing with difficult suppliers;
  • Liaise with Fraud Management and legal teams;
  • Evaluate evidence on an ongoing basis until the validity of the issue in question can be determined;
  • Conduct Examinations Under Oath;
  • Complete or provide technical expertise in completing over the phone or in person statements;
  • Finalize and submit Materiality Tests for Underwriting Investigations.

    Claims Handling

  • Ensuring prompt and equitable investigation in accordance with corporate procedures and legislation to allow Claim Advisors to reach a timely resolution;
  • Responsible to ensure all correspondence is completed in a time efficient / effective manner, including appropriate insurance forms, proof of loss form, and reservation of rights letters, etc.
  • Review and compile facts, policy, and technical reports;
  • Responsible for recognizing recovery opportunities;
  • Effectively advise and counsel Claim Advisors and / or customers on claim status; provide prompt and exemplary customer service while keeping related parties informed.
  • Required Knowledge, Skills & Experience

  • Post-secondary education insurance related preferred;
  • CIP designation or working towards CIP;
  • Minimum 5 years of experience adjusting property claims, including specialization in handling deceitful claimants and policyholders and difficult suppliers;
  • Strong technical knowledge specific to claims line of business.
  • Highly organized individual with a capability to prioritize tasks on an on-going basis;
  • Investigative or litigation background an asset.
  • Strong understanding of claims and underwriting processes;
  • Superior analytical, problem-solving and decision-making skills;
  • Leadership abilities, coaching and team-building skills;
  • Excellent presentation skills;
  • Aptitude for learning and development initiatives;
  • Excellent communication skills, both verbal and written;
  • Strong customer service skills ability to communicate diplomatically and empathetically throughout the claim and investigation process ;
  • Assertive and comfortable with challenge and ambiguity.
  • Investigative competency

  • Ability to diffuse / de-escalate combative situations; and
  • Strong technical knowledge of property policies and applicable Statutory Conditions and related legislation;
  • Ability and high comfort level to take a detailed and informative recorded, telephone or in-person statements from the insured and / or involved witnesses.
  • Strong analytical skills with a great attention to detail and the ability and focus to determine the direction of an investigation, while keeping timelines as an ongoing priority.
  • Aviva Canada is committed to providing accommodations for people with disabilities during all phases of the hiring process including the application process.

    If you require an accommodation because of a disability, we will work with you to meet your needs. Applicants need to make their needs known in advance.

    If you are selected for an interview and require an accommodation, you are encouraged to advise the Talent Acquisition Partner who will consult with you to determine an appropriate accommodation.

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