Bilingual Claims Examiner, Living Benefits Claims
Canada Life
Winnipeg, MB, CA
2d ago

Our Story

We are proud to announce that Canada Life will become our company brand under which our three companies service Great West Life, London Life, and Canada Life.

Together, Great-West Life, London Life and Canada Life have been in the business of keeping promises for over a century.

The new Canada Life brand combines the strengths of all three so we can better deliver on our purpose : To improve the financial, physical and mental well-being of Canadians.

We are excited about this journey. To find out more about our story, click here

Role Description

Adjudicate DI claims in accordance with sound adjudication practices and the terms of the actual policy. This will result in satisfactory morbidity experience while maintaining good relations with our field force and policyholders.

This job has the potential of directly affecting our marketing efforts and our position in the marketplace.

Accountabilities :

  • Adjudicating ongoing Great-West Life individual disability insurance claims. These ongoing / long term disability claims are cases we have been paying benefits for more than 5 years.
  • Will also manage waiver only claims.

  • Assess the various policy provisions and the medical condition causing disability. Develop the claim file by assessing various factors (occupation, finances, medical, etc.
  • required to assess the disability.

  • Review all information when received and arrive at a decision to either accept, deny or continue with benefits. This involves researching the medical condition, consulting if required, the medical board, product actuary, legal counsel, accountant, peers, superiors and psychiatric consultant.
  • Decision must be documented clearly for legal, audit purposes and privacy issues.

  • Communicate by email, telephone, letter, etc. with policyholders, office staff, physicians, hospitals, agents, brokers, lawyers, for the purpose of requesting information, explaining and defending claim policies and guidelines.
  • Most information communicated is of a very sensitive nature where the potential for much friction exists.

  • Projects (surveys, research, etc.) as assigned.
  • Qualifications and Competencies :

  • Excellent verbal and written communication skills in both English and French
  • Good understanding of a PC and word processing application
  • Good organization skills
  • Good analytical skills
  • Apply
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