Job Description:
Role Overview
We are seeking an experienced Life Insurance Claims Specialist with solid expertise in Life Insurance and Living Benefits Claims administration to support Canadian insurance operations. The ideal candidate will have extensive experience handling end-to-end claims processing, excellent client servicing capabilities, and fluency in both French and English. This role requires close collaboration with onshore stakeholders, clients, and internal teams to ensure accurate and timely resolution of claims while maintaining high service standards and regulatory compliance.
Key Responsibilities
Process and adjudicate Life Insurance and Living Benefits Claims for Canadian policyholders in accordance with company guidelines, service-level agreements (SLAs), and regulatory requirements.
Review claim documentation, validate policy provisions, assess eligibility, and determine claim outcomes with accuracy and attention to detail.
Coordinate with onshore teams, business partners, and clients to resolve claim-related queries and ensure seamless transaction processing.




Manage claim cases from initiation through closure, ensuring all required documentation is collected, reviewed, and maintained.
Identify missing information and proactively follow up with customers, beneficiaries, healthcare providers, or internal stakeholders to facilitate claim completion.
Maintain accurate records and update claims management systems with all relevant activities and decisions.
Monitor claim turnaround times and ensure adherence to quality standards and operational KPIs.
Support investigations and escalation management for complex or exceptional claim scenarios.
Participate in process improvement initiatives aimed at enhancing operational efficiency, customer experience, and quality outcomes.
Ensure compliance with Canadian insurance regulations, internal policies, and data privacy requirements.
Collaborate with quality, training, and operations teams to drive continuou

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