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Td Bank TD Insurance Senior Investigator Special Investigations Unit Canada, Quebec, Montreal 53891756
PRIMARY PURPOSE OF THE JOB
Identify, investigate, and mitigate instances of suspected insurance fraud to protect the organization from financial losses while ensuring compliance with regulatory and legal standard.
This role involves leading comprehensive investigations into complex fraud cases, gathering and analyzing evidence, and collaborating with internal teams and external entities such as law enforcement and regulatory agencies.
The Senior Investigator plays a critical role in maintaining the integrity of the claims process by detecting fraudulent activity, preventing future occurrences, and ensuring that legitimate claims are processed efficiently and accurately.
Customer
Make recommendations for enhancements that will create or enhance fraud detection techniques that mitigate exposure without sacrificing the customer experience.
Conduct comprehensive investigations into suspected fraudulent claims to protect the organization and ensure fairness to all customers, including those filing legitimate claims.
Collect, analyze, and preserve evidence in compliance with legal standards, ensuring all findings support accurate claim resolutions.
Maintain a focus on minimizing fraudulent activities without causing undue delays or burdens on legitimate claimants.
Communicate investigation outcomes clearly and professionally to internal and external customers, such as claimants, policyholders, and legal representatives.
Provide updates to claimants and relevant stakeholders during investigations, ensuring transparency and alignment with customer service standards.
Act as a steward of trust by identifying and addressing fraudulent activity that could compromise the integrity of the claims process, thereby safeguarding the interests of honest customers.
Ensure compliance with legal, regulatory, and ethical standards in all investigative actions to protect the organization’s reputation and maintain customer confidence.
Prioritize timely investigations to ensure legitimate claims are resolved quickly and efficiently without unnecessary delays for policyholders.
Balance investigative thoroughness with service excellence to achieve outcomes that are fair and just for all customers.
Handle all customer and claim information with the utmost confidentiality and in compliance with privacy laws and organizational policies.
Safeguard sensitive information to protect customers from further harm or risk associated with fraud.
Shareholder
Prioritize and manage own workload to meet SLA requirements for service and productivity.
Consistently exercise discretion in managing correspondence, information and all matters of confidentiality; escalate issues where appropriate.
Be knowledgeable of practices and procedures within own area of responsibility and keep abreast of emerging trends for own functional area.
Understand and apply operating policies and procedures.
Follow internal and industry regulations and operating practices in completing and recording transactions for either the organization or clients.
Ensure documentation that is prepared / completed is accurate and properly reflects business intentions and is consistent with relevant rules / regulations.
May lead work streams by acting as a project lead / subject matter expert for small scale projects / initiatives in accordance with project management methodologies.
Complete investigations – report / escalate risk issues or process gaps identified.
Identify and recommend opportunities to enhance productivity, effectiveness and operational efficiency.
Ensure necessary due diligence to support the accuracy of all transactions / activities.
Maintain a culture of risk management and control, supported by effective processes in alignment with risk appetite.
Be knowledgeable of and comply with Bank Code of Conduct
Employee/Team
Participate fully as a member of the team, support a positive work environment that promotes service to the business, quality, innovation and teamwork and ensure timely communication of issues/ points of interest.
Support the team by continuously enhancing knowledge / expertise in own area and participate in knowledge transfer within the team and business unit.
Keep current on emerging trends/ developments and grow knowledge of the business, related tools and techniques.
Participate in personal performance management and development activities, including cross training within own team.
Keep others informed and up-to-date about the status / progress of projects and / or all relevant or useful information related to day-to-day activities.
Contribute to the success of the team by willingly assisting others in the completion and performance of work activities; provide training, coaching and/or guidance as appropriate.
Contribute to a fair, positive and equitable environment that supports a diverse workforce.
Act as a brand champion for your business area/function and the bank, both internally and/or externally.
BREADTH & DEPTH
Serves as a subject matter expert in operational function and performs end to end activities, may serve as knowledge and process expert to others.
Requires advanced understanding of a range of product and services, processes, procedures, systems and concepts within their own area of specialty and integration points with related areas.
Applies advances knowledge of business drivers, processes, and customers to coordinate with other related areas to improve efficiency and deliver results.
Manages ambiguity, and applies judgement to identify, troubleshoot and resolve ongoing business and operational issues.
Interprets and administers policies, adopts and implements business process improvements.
Impacts the quality, efficiency and ongoing operations of one or multiple units.
May represents as a project lead on projects / initiatives and/or at meetings across the organization.
Reports to a Group Manager.
Job Requirements
5+ years of relevant experience.
CIP preferred.
Claims adjustment (in personal-lines) license issued by l'Autorité des marchés financiers (AMF)
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.
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. Whether you have a passion for helping customers and want to expand your experience, or you want to coach and inspire your colleagues, there are many different career paths within our organization at TD – and we’re committed to helping you identify opportunities that support your goals.
We will provide training and onboarding sessions to ensure that you’ve got everything you need to succeed in your new role.
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