Living Benefits Claim Adjudicator-0900503
Primary Location: Toronto, Ontario
Organization: Individual Insurance Living Benefits Claims
Description
Manulife Financial’s Individual Insurance organization is a leading provider of insurance products to Canadian families, individuals and businesses. We are recognized in the marketplace for our innovative products, excellent service and professional, expert advice.
We are currently seeking a Living Benefits Claims Adjudicator for a client base across Canada. Product Lines include Individual Disability, Critical Illness, Life Waiver of Premium and eventually Long Term Care Policies. Applicants must be willing to work in a team environment
Responsibilities:
.Establish and maintain exemplary customer service to policyholders, agents, marketing centers, etc in all provinces
.Obtain proper file information and review with policy provisions to verify eligibility
.Manage ongoing claims by requesting further medical, financial documentation or investigations as required and consult with specialists in all areas.
.Review claims and underwriting files for proper disclosure of past medical history, exclusions, riders, endorsements; administer policy enhancements, premium waiver and other policy benefits
.Document the claim file to ensure an accurate record of events that transpire in the claim handling
.Manage litigation claims ensuring controls are maintained and cases move forward at an appropriate rate; suggest and review litigation reserves and provide quarterly updates
.Attend Examination for Discoveries, Mediations and attend court trials
.Accurately maintain claim records on System to ensure accuracy of reserve calculations
.Reconcile open claims files to actuarial records on a semi-annual basis
Qualifications
.2-3 years experience in adjudicating disability and critical illness claims (individual claims preferred).
.Customer service oriented individual with negotiating skills is essential.
.Excellent interpersonal skills with good oral and written communication skills for use in dealing with internal and external customers, claimants, brokers, physicians, employees, hospitals, investigators and lawyers.
.Must have a good working knowledge of medical conditions and terminology, as well as experience in the interpretation and application of financial documentation and fair claims practices.
.Must have working knowledge of government legislation and legal precedents, the Insurance Act.
.Ability to respond constructively and decisively in high pressure or emotional situations and to respond positively to change.
.Good analytical skills to evaluate conflicting information from various key sources in order to assess risk in making timely and effective decisions with appropriate interpretation of policies and procedures.
.Good working knowledge of the underwriting process.
.Ability to handle discoveries/trials re litigation
Attributes:
.Customer service oriented individual with good negotiating skills is essential
.Proven ability to make decisions and handle pressure
.Ability to work in a team environment
Special Conditions: Overtime may be required during peak periods.Occasional travel to attend litigation activities.
About Manulife Financial
Manulife Financial is a leading Canadian-based financial services group serving millions of customers in 19 countries and territories worldwide. Operating as Manulife Financial in Canada and Asia, and primarily through John Hancock in the United States, the Company offers clients a diverse range of financial protection products and wealth management services through its extensive network of employees, agents and distribution partners. Funds under management by Manulife Financial and its subsidiaries were Cdn $404.5 billion (US$330.3 billion) as at December 31, 2008. Manulife Financial Corporation trades as ‘MFC’ on the TSX, NYSE and PSE, and under ‘945′ on the SEHK. Manulife Financial can be found on the Internet at www.manulife.com.
How to Apply:
Fill form at Manulife’s website by clicking HERE
