Intermediate Claims Adjuster

Adjudicate contested and complex accident, life, critical illness, cancer, and sickness disability claims..

Approve, deny, or inquire further for necessary information from claimants, doctors or hospital to assess claimant’s eligibility for benefits.

Interprets and administers policy provisions including, but not limited to eligibility, definition of total disability, and pre-existing investigations.

Review incoming correspondence concerning existing claims.

Review and make decisions for policy rescission, after discussion with underwriting. Adjudicate contested and complex accident, life, critical illness, cancer, and sickness disability claims..

Approve, deny, or inquire further for necessary information from claimants, doctors or hospital to assess claimant’s eligibility for benefits.

Interprets and administers policy provisions including, but not limited to eligibility, definition of total disability, and pre-existing investigations.

Review incoming correspondence concerning existing claims.

Review and make decisions for policy rescission, after discussion with underwriting.

Refer files for special investigation if required.

Other duties as required.

QUALIFICATIONS REQUIRED

• Minimum high school education or college diploma
• Minimum 2 years of claims adjudication experience;
• Bilingual (Fluent in French and English);
• Good communication skills, both verbal and written;
• Mathematical skills - Aptitude for figures;
• Ability to make good decisions and use sound judgment;
• Strong knowledge of medical terminology
• Insurance courses such as LOMA and HIAA