Catastrophic Claims Advisor

Desjardins; Aurora; Hybrid; CAD 75,000 - 110,000; Full time

Benefits offered by this job

Competitive salary and annual bonus

4 weeks of flexible vacation starting

Defined benefit pension plan

Group insurance including telemedicine

Reimbursement of health and wellness +

telework equipment

Job summary

Desjardins in Ontario seeks a Catastrophic Claims Advisor to expertly handle complex accident benefits claims. You will partner with healthcare providers, legal teams, and rehabilitation specialists to guide clients through the process and focus on functional recovery.

Role requires five years of related experience, CIP designation or enrollment, and strong English communication. You will support settlements, manage LAT disputes, and ensure timely claim payments with equity and empathy.

Qualifications

• Bachelor’s degree in a related field.
• Five years of experience in accident benefits claim handling.
• Advanced knowledge of the Statutory Accident Benefits Schedule.
• CIP designation or enrollment in the program.
• Advanced English proficiency for interactions with partners and clients.
• Experience with medical and disability files and regulatory obligations.

Responsibilities

• Investigate, evaluate and negotiate high-complexity accident benefit claims.
• Maintain clear and timely communication with clients about claim status.
• Manage catastrophic claims with focus on functional recovery.
• Identify and resolve challenges to achieve fair outcomes and client well-being.
• Conduct settlement discussions and negotiate resolutions when needed.
• Collaborate with internal/external counsel on LAT disputes and hearings.
• Coordinate with medical professionals, legal reps and rehab providers to support recovery.
• Apply accurate reserving and ensure timely claim payments per standards.

Skills

Advanced English

Disability management concepts

Regulatory knowledge

Complex negotiation

Client advocacy

Team collaboration

Education

Bachelor’s degree in related field

CIP designation or enrolled in program

Job description

We are seeking highly skilled and empathetic Ontario Accident Benefits Claims professional, looking for an opportunity to make a meaningful impact on the lives of our clients while working in a dynamic, supportive, and collaborative environment. The Catastrophic Claims Advisor serves as a trusted guide and advocate for clients navigating complex catastrophic claims. Partnering with healthcare providers, legal representatives, rehabilitation specialists, and other key stakeholders, the advisor provides guidance, advocacy, and coordination throughout the claims process. Combining technical expertise with professionalism, empathy, and compassion, the role focuses on supporting each client’s functional recovery, and ensuring their unique needs are met through a personalized, client-centered approach. You will be a key contributor to our mission of delivering exceptional claims service and client care. More specifically, you will be required to:

• Investigate, evaluate and negotiate accident benefit claims of high complexity, ensuring compliance with regulatory and contractual obligations, as well as DGIG best practices
• Maintain clear and timely communication with clients, providing updates on the status of their claims, addressing inquiries and guiding them through the claims process
• Manage Catastrophic claims with a keen focus on functional recovery
• Identify and resolve challenges, including complex or sensitive issues, with a focus on achieving fair outcomes and supporting client well-being
• Conduct settlement discussions and negotiate resolutions where appropriate
• Collaborate with internal and external legal counsel on LAT disputes, reconsiderations, judicial reviews, mediations, and hearings
• Collaborate effectively with internal and external stakeholders - such as medical professionals, legal representatives, and rehabilitation providers - to support client recovery and claim resolution
• Apply accurate reserving practices and ensure timely issuance of claim payments in accordance with company standards and best practices.

What we offer*

• Competitive salary and annual bonus
• 4 weeks of flexible vacation starting in the first year
• Defined benefit pension plan that provides predictable, stable income throughout retirement
• Group insurance including telemedicine
• Reimbursement of health and wellness expenses and telework equipment

*Benefits apply based on eligibility criteria.

#LI-Hybrid, #ON09*

What you bring to the table

• Bachelor’s degree in a related field
• A minimum of five years of relevant experience in accident benefits claim handling
• Please note that other combinations of qualifications and relevant experience may be considered
• Advanced experience managing medical and disability files within the constraints of the Statutory Accident benefits schedule with a focus on functional recovery
• CIP designation or enrolled in the program
• Advanced proficiency of English due to the nature of the duties or work tools or because the position involves interactions with English-speaking partners, members and/or clients
• Advanced knowledge of regulatory and contractual obligations (Statutory Accident Benefits Schedule)
• Advanced knowledge of medical and legal terminology, vocational rehabilitation concepts and disability management principles
  Action oriented, Business insight, Complexity, Customer Focus, Decision quality, Differences, Interpersonal Savvy, Nimble learning

Equity, Diversity, Inclusion and Accessibility

At Desjardins, we believe in equity, diversity and inclusion. We’re committed to welcoming, respecting and valuing people for who they are as individuals, learning from their differences, embracing their uniqueness, and providing a positive workplace for all. At Desjardins, we have zero tolerance for discrimination of any kind. We believe our teams should reflect the diversity of the members, clients and communities we serve.

If there’s something we can do to help make the recruitment process or the job you’re applying for more accessible, let us know. We can provide accommodations at any stage in the recruitment process. Just ask!

Trade Union (If applicable)

Job Family

Member/client sales and service (FG)

Unposting Date

2026-11-11