Claims Specialist

TD Bank Group; Burlington; Hybrid; CAD 79,000 - 112,000; Full time

Job summary

TD Bank Group is recruiting a Claims Specialist for Accident Benefits in Burlington, Ontario. You will identify client needs, thoroughly investigate claims, and determine eligibility for benefits to promote recovery and timely return to function.

The role requires handling complex cases with high exposures, maintaining accurate reserves, and participating in related meetings. Strong communication, leadership, and analytical abilities are essential for success.

Qualifications

• Five years of experience in case managing Accident Benefit claims.
• Ability to communicate effectively with clients and internal/external stakeholders.
• Demonstrated leadership and ability to meet deadlines.
• Strong analytical skills and attention to data accuracy.
• Knowledge of auto policy documents and related medical terminology.

Responsibilities

• Identify and meet client needs with urgency, ensuring timely investigation of complex claims.
• Assess eligibility and entitlements, access to benefits, and support client recovery.
• Handle claims involving high exposures, participate in large loss meetings when needed.
• Record and verify information, analyze facts, and ensure documentation quality.
• Meet productivity objectives and apply protocols for cost-effective results.

Skills

Case management

Claims handling

Communication skills

Leadership

Time management

Analytical skills

Negotiation

Written communication

Job description

Work Location: Burlington, Ontario, Canada Hours: 35 Line of Business: TD Insurance Pay Details: $79,100 - $111,700 CAD

TD is committed to providing fair and equitable compensation opportunities to all colleagues. Growth opportunities and skill development are defining features of the colleague experience at TD. Our compensation policies and practices have been designed to allow colleagues to progress through the salary range over time as they progress in their role. The base pay actually offered may vary based upon the candidate's skills and experience, job-related knowledge, geographic location, and other specific business and organizational needs. As a candidate, you are encouraged to ask compensation related questions and have an open dialogue with your recruiter who can provide you more specific details for this role.

Job Description

Additional Job Description TD Insurance is part of TD Bank Group, one of Canada’s largest financial institutions. TD Insurance helps protect clients from the ‘accidents of life’ with a wide range of products including credit protection, life, health, travel, home and auto insurance. With more than three million clients, TD Insurance authorized products and services are available online, over the phone, and through a network of more than 1,000 TD Canada Trust branches. In Canada, we have two lines of business, General Insurance and Life and Health. Our General Insurance business is one of the top home and auto insurance groups in Canada and the national leader in group insurance and affinity marketing. Our Life and Health business is the number one provider of critical illness insurance and direct life and health insurance in Canada. At TD Insurance, we are committed to fostering an inclusive, accessible environment. With a Canada-wide workforce of over 4,000 employees and offices in Atlantic Canada, Quebec, Ontario and Alberta, our company is always growing and can help you to grow. TD Insurance offers a stable and dynamic work environment where talent is appreciated and professional development is taken seriously. More than just a job, we offer rewarding careers.

Job Description

Reporting directly to a Team Leader, key responsibility of the Claims Specialist, Accident Benefits, is to act with a sense of urgency in identifying and meeting client needs. This includes ensuring timely & thorough investigation of claims involving predominantly complex issues and/or high exposures, identifying client eligibility and/or entitlement, and ensuring quick access to all available benefits in order to promote treatment and recovery, and to help the client return to optimal function. Responsible for case handling of claims involving predominantly complex issues and/or high exposures including catastrophic injuries; priority of payment, loss transfer and loss reserving. Some participation may be required in large loss meetings, mediations, arbitrations and litigations. Ensure accurate and timely reserves and take a total cost management approach to claims. Record and verify information and documentation from all available sources to ensure a thorough and complete compilation of facts required to resolve the claim; and identify potential coverage issues and/or recovery/liability opportunities. Using established protocols, analyze and evaluate facts of an individual case to assess the benefits available to the client. Make good decisions based upon a mixture of analysis, wisdom, experience, and judgement. Read and remain current and up to date on case law, legal changes and recent settlements which affect accident benefit claims. Apply departmental protocols to ensure efficient, productive and cost effective results. Meet productivity objectives set by the department in terms of pending file count and open/close ratio.

Job Requirements

• 5 years experience in case managing Accident Benefit claims
• Strong communication skills, listening and responding with authority and compassion.
• Proven ability to communicate effectively and interact successfully with internal and external clients.
• Demonstrated leadership skills.
• Strong time-management, demonstrated accuracy and ability to meet deadlines
• Strong analytical skills, recognizing discrepancies and/or gaps in data and reports and use effective questioning techniques
• Strong negotiation skills, focused on win/win outcomes when possible
• Strong written communication, clear and professional letters conveying appropriate type and amount of information
• Effectively interpret the standard auto policy and medical documents and have advanced knowledge of the human anatomy.

Who We Are

As part of TD Bank Group, one of Canada's largest financial institutions, at TD Insurance, we care for Canadian families, making it easy to get the best advice, protection, and support in their moments of need, always. TD Insurance offers a wide range of products, including General Insurance and Life and Health. Everyday, we strive to make every interaction, product and experience remarkably human and refreshingly simple for more than four million customers who count on us.

Our Total Rewards Package

Our Total Rewards package reflects the investments we make in our colleagues to help them and their families achieve their financial, physical, and mental well-being goals. Total Rewards at TD includes a base salary, variable compensation, and several other key plans such as health and well-being benefits, savings and retirement programs, paid time off, banking benefits and discounts, career development, and reward and recognition programs.

Additional Information

We’re delighted that you’re considering building a career with TD. Through regular development conversations, training programs, and a competitive benefits plan, we’re committed to providing the support our colleagues need to thrive both at work and at home. Please be advised that this job opportunity is subject to provincial regulation for employment purposes. It is imperative to acknowledge that each province or territory within the jurisdiction of Canada may have its own set of regulations, requirements.

Colleague Development

If you’re interested in a specific career path or are looking to build certain skills, we want to help you succeed. You’ll have regular career, development, and performance conversations with your manager, as well as access to an online learning platform and a variety of mentoring programs to help you unlock future opportunities. If you’re passionate about helping clients and building deep, lasting relationships, TD offers diverse career paths where you can grow your expertise and make a meaningful impact. We're committed to your success and foster a respectful workplace where diverse perspectives are valued, everyone has fair opportunities to grow, and you can unlock your full potential to achieve your career goals. Here at TD, we hire and develop the best.

Training & Onboarding

We will provide training and onboarding sessions to ensure that you’ve got everything you need to succeed in your new role.

Interview Process

We’ll reach out to candidates of interest to schedule an interview. We do our best to communicate outcomes to all applicants by email or phone call.

Accommodation

Your accessibility is important to us. Please let us know if you’d like accommodations (including accessible meeting rooms, captioning for virtual interviews, etc.) to help us remove barriers so that you can participate throughout the interview process.

Language Requirement (Quebec only)

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Our Values

At TD we’re guided by our purpose to enrich the lives of our customers, communities and colleagues, and share a set of values that shape our culture and guide our behavior. In exchange for how our colleagues show up to help TD succeed, we are committed to delivering a colleague experience grounded in Impact, Growth and a Culture of Care. No matter where you work across TD, we empower you to make an impact at work and in your community, explore and grow your career and be part of our caring and inclusive culture.

Our Commitment to Diversity, Equity, and Inclusion

At TD, we’re committed to fostering an environment where all colleagues are encouraged to bring their authentic selves to work, experience equitable opportunities, and feel respected and supported. We’re dedicated to building an inclusive workforce that reflects the diversity of the customers and the communities in which we live and serve.

Helping to Make an Impact in Communities – TD Ready Commitment

TD has a long-standing commitment to help drive progress towards a more inclusive and sustainable future. That’s why we launched the TD Ready Commitment in 2018, now a multi-year North American initiative. Under the TD Ready Commitment, we are targeting a total of C$1 billion by 2030 in community giving across four key, interconnected drivers of change: Financial Security, Vibrant Planet, Connected Communities, and Better Health. It’s our goal to help support change, nurture progress, and contribute to making the world a better, more inclusive place for our customers, colleagues, and communities. Learn more: Canada | US | Europe & Asia Pacific