Claims Examiner III, Creditor Life & Distribution

The-Sovereign-General-Insurance-Company; New Jersey; Hybrid; USD 54,000 - 65,000; Full time

Benefits offered by this job

Paid time off

Training and development

Volunteer days

Total rewards package

Job summary

CUMIS Union is seeking a Claims Examiner III in a hybrid role based in Canada. You will adjudicate creditor life and disability claims, build case management plans, and determine claim eligibility while handling complex portfolios over $50,000 in coverage.

You will review medical information, interview claimants and employers, and communicate decisions. A post-secondary diploma and LOMA credentials are required, with development opportunities and comprehensive benefits.

Qualifications

• Completion of a post-secondary diploma with 2 years customer service experience.
• 2 years disability claims management experience preferred.
• Completion of LOMA 280 & 290 required.
• ALHC, degree in a related discipline preferred.
• Knowledge of creditor products.

Responsibilities

• Review current and historical medical information to assess misrepresentation in applications.
• Communicate rescission decisions to policyholders and parties.
• Ensure accuracy of information supporting a new claim.
• Interview claimants, employers, or loan officers by telephone.
• Determine claim payability and develop case management plans to minimize disability duration.
• Initiate assessments and examinations when necessary.
• Review claims for changes in definition and occupations.

Skills

Customer service

Communication skills

Team player

Adapt to change

Education

Post-secondary diploma

LOMA 280 & 290

Tools

LOMA 280

LOMA 290

Job description

Job Details

Posting Details

• Posted on November 5, 2026
• Requisition #: CLAIM007074

Locations

Showing 1 location Burlington, ON, CAN

• Hybrid
• Claims
• Full-Time

Description

Company: CUMIS Union

Department: Creditor Claims

Employment Type: Regular Full-Time

Work Model: Hybrid (2 days in office)

Language: This role operates in English.

The Opportunity:

We are a leading Canadian financial services co-operative committed to being a catalyst for a sustainable and resilient society and our team is essential to deliver on this strategy. That’s why we prioritize our people, to ensure we provide a strong culture and development opportunities which enables our team to thrive and to live our purpose. The best part is that you will work with people that care passionately about you, our clients and our communities.

The Claims Examiner III, Creditor Life and Disability adjudicates and manages a caseload of creditor Group Mortgage Protection (GMP) and Monthly Premium over $50,000 (MP) disability and life claims. This role is also responsible for adjudicating and managing claims for other creditor disability products including Loss of Employment (LOE), and where combined coverage exists, Single Premium (SP), Monthly Premium (MP) and Credit Card. This role assesses eligibility for disability and life benefits, develops case management plans, initiates, and implements interventions to minimize claim durations, authorizes and issues disability benefits.

How you will create impact:

• Through the review of current and historical medical information assess the initial insurance application to determine if a material misrepresentation (including fraudulent misrepresentation) has been made by the policyholder.
• For policies that are rescinded as a result of misrepresentation, communicate the decision to the appropriate parties including the policyholder.
• Ensure accuracy of, assess and review all information received in support of a new claim
• Interview claimants, employers, loans officers by telephone prior to making claim decisions
• Using the information received, the additional information gathered and the resources available and in accordance with policy provisions determine if the claim is payable.
• For each claim, develop and execute a proactive case management plan with the objective of minimizing the disability period.
• Initiate assessments and examinations where necessary.
• Proactively assess and review claims for change of definition including identifying alternative occupations and communicating change of definition decisions.

To join our team:

• Completion of a post-secondary diploma with 2 years customer service experience, 2 years disability claims management experience preferred.
• Medical anatomy College or University equivalent or ICA CI required.
• Completion of LOMA 280 & 290 required.
• ALHC, degree in a related discipline preferred.
• Knowledge of creditor products.

How you will succeed:

• You adapt to change and are committed to continuous improvement, in order to exceed client expectations.
• Your strong communication skills allow you to clearly convey messages.
• You’re an effective team player who shares knowledge to support your peers.

What you need to know:

• You will be subject to a Background check as a condition of employment, in the event you are the successful candidate.

What’s in it for you?

• Training and development opportunities to grow your career.
• Paid time off to support your personal and family needs.
• A holistic approach to your well-being, with a supportive workplace culture.
• Paid volunteer days to give back to your community.
• A comprehensive total rewards package, including competitive salary, pension and benefits.

Expected salary range $83,936

The salary amount for the successful candidate is determined by Co-operators in its discretion and will vary depending on several criteria including but not limited to: local market conditions, geography and relevant job-related factors such as knowledge, skills, qualification, experience and education.

Employees may also have the opportunity to participate in incentive programs and earn additional compensation tied to individual and/or business performance, or other business metrics.