Senior Special Investigator, Corporate Claims

Located in Ontario and Nova Scotia, Heartland Mutual Insurance strives to be the Best Mutual. Our team of talented and dedicated professionals challenge the norm and strive to be extraordinary. It's all about fulfilling our promise with a personal approach. With our team, you'll bring this purpose to life every day by living our values, being open to change, and pursuing your career aspirations.

What you will do...

• Independently investigate complex and high-risk claims with suspected fraudulent activity.
• Manage an investigative claims caseload, actively making coverage determinations, adjusting reserves, and directly handling claims when appropriate.
• Prepare comprehensive reports summarizing investigative findings, evidence gathered, and recommendations for claims disposition.
• Partner closely with UW to evaluate issues, assessing impacts on coverage and policy terms.
• Provide expert recommendations to UW for effective risk assessment and decision-making.
• Lead proactive fraud detection initiatives, identifying emerging trends and high-risk indicators.
• Collaborate closely with Claims team to provide training and guidance on fraud recognition and early intervention strategies.
• Develop and maintain strong relationships with external law enforcement agencies, industry fraud bureaus, and investigative networks to enhance fraud detection capabilities.
• Maintain meticulous documentation and audit trails for all investigative activities.
• Engage actively with internal stakeholders to provide investigative expertise and insights.
• Contribute to training programs focused on fraud awareness, investigative techniques, and claims handling best practices.
• Collaborate with the Manager, Corporate Claims, to establish robust reporting systems capturing investigative outcomes, fraud trends, and financial impacts.

What you will bring...

• 7-10 years in claims investigation, fraud detection, or related fields, with direct claims handling and investigative experience.
• Demonstrated experience working with Underwriting on complex materiality assessments.
• Post-secondary education in Business, Insurance, Criminology, or related field; CIP or relevant investigative certifications strongly preferred.
• Extensive knowledge of claims investigative methodologies, legal processes, and fraud detection techniques.
• Proficient with claims management and investigative software, analytical tools, and reporting systems.
• Exceptional analytical, critical-thinking, and investigative skills.
• Strong interpersonal, negotiation, and communication abilities.
• Demonstrated ethical judgment, integrity, and professionalism.
• Proven ability to collaborate effectively across diverse teams and with external partners, including law enforcement and regulatory bodies.

What we offer...

In return, we'll give you countless opportunities to learn and grow. You'll be empowered to be your best self, do your best work, and make a meaningful impact. Here, you can help shape the future of insurance, win as a team, and grow with us.
At Heartland our benefits are great and include not only health and dental coverage, but also a generous pension plan. All staff members share in our company's success through our incentive plan. And with our hybrid work model, you get the best of both worlds - the ability to collaborate and connect with great colleagues and to enjoy the benefits of working from home.

Intrigued? We can't wait to hear from you!

If you have the qualifications we are seeking and would thrive in a work environment where you are valued and respected, please apply on the company website. Accommodations are available on request for candidates taking part in all aspects of the selection process.

A Place Where YOU Can Make a Difference! Proudly Canadian. Mutually Owned.