Conducts expert disability claims adjudication within internal standards, delegated authority limits and client response timelines.
Monitors coverage assessment including promptly identifying, addressing and resolving coverage matters.
Proactively investigates, assesses, manages and resolves claim inconsistencies with clients.
Promptly approves payments in accordance with payment authorization protocols and client service level agreements.
Establishes strongly positive, mutually beneficial, long-term client relationships through professional and knowledgeable communication.
Monitors client claim results and provides business partners with accurate client information on a timely basis through claim analytics, data mining and trend analysis.
Assists with identifying / implementing initiatives to enhance claim handling efficiencies and effectiveness.
Risk Monitoring and Claim Reviews
Identifies and communicates exceptions to reinsurance treaty terms and claims where non-compliance exists to the internal business partners and provides recommendations for resolution.
Performs client reviews according to reinsurance treaty contracts; produces excellent written analytical review reports with sound recommendations.
Conducts client review result presentations; follows up on recommended client actions to improve client review results.
Presents claims to Senior Management for evaluation / authority including completion of pertinent claim summary reports and notice of high exposure claims.
Creates and delivers presentations and training programs for clients and internal business partners, via industry seminars or internal publications.
Delivers leading-edge knowledge of individual and group disability insurance claim investigations and practices to clients and internally.
Applies expert risk management knowledge to client claim situations and shares expertise throughout the Munich Reinsurance Group e.
g. product development, contract wording.
Engages with pricing, underwriting, and legal to ensure treaty and contractual liabilities, product language, client underwriting and claim decisions meet Munich Re’s risk standards and intent.
Required Knowledge, Skills, and Experience
University degree in combination with CEBS, CSPDM, FLMI or other insurance designation.
Minimum 5 years of Group insurance experience with thorough knowledge of group disability claims. Exposure to different group types (union and non-union for example),complex claims and to claims under Life coverage is an asset.
Bilingual (English / French) written and spoken is required
Exhibits thoroughness, accuracy and attention to detail in claim reviews and data capture.
Strong analytical and inquisitive skills; excellent ability to provide timely service and achieving deliverables.
High degree of self-motivation, continuing development and proven ability to work independently.
Demonstrated desire and aptitude to learn other lines of business and claim types.
Excellent presentation and report creation and delivery skills. Strong oral and written communication skills.
Demonstrated ability to build solid client relationships.
Related experience in reinsurance and knowledge of underwriting / medical concepts and terminology will be an asset.
Thorough working knowledge of Microsoft Office suite and Excel.
Travel within Canada is required.