Claim Adjudication Conduct expert individual claim adjudication within internal quality standards, delegated authority limits, and client response timelines. Identify coverage and payment discrepancies, address and resolve coverage anomalies. Proactively identify, assess, manage and resolve claim evidence inconsistencies with clients. Promptly approve payments in accordance with payment authorization protocols and client service level agreements. Archive all claim documentation in an appropriate and orderly manner, perform required claim file follow‑ups. Utilize data management and claim system software and tools effectively to adjudicate and monitor claim risks. Client Management Establish strongly positive, beneficial long‑term client relationships through professional, timely, and knowledgeable communication. Monitor client claim results and provide accurate client information on a timely basis to Management through claim analytics, data mining and trend analysis. Assist with identifying/implementing initiatives to enhance claim handling efficiencies and effectiveness. Develop and implement strategies to track and improve claim results or client expertise. Risk Monitoring and Claim Audits Validate treaty compliance during client claim audits, communicate findings to internal business partners, and provide best practice recommendations for action/resolution. Produce excellent written analytical client audit reports with sound recommendations within expected timeframes. Follow up on recommended client actions to improve client review results. Present claims to Senior Management for evaluation/authority including completion of pertinent claim summary reports and notice of high exposure claims. Knowledge Transfer Provide technical mentoring on complex claims to clients or internal Claims team members. Develop and deliver leading‑edge knowledge of insurance claim investigations and practices through presentations, surveys and publications. Engage with pricing, underwriting, and legal to ensure treaty and contractual liabilities, product language and client decisions meet Munich Re’s risk standards and intent. Apply expert risk management knowledge/analysis to claim scenarios and share expertise throughout the organization. Your Profile Minimum 3-5 years in insurance claims, with expertise in Individual Life, Critical Illness and/or Disability claims. Reinsurance experience is an asset. Bilingual in English/French, is an asset. Bachelor’s degree. LOMA, ICA or other insurance designations, preferred. Requirement to work in Toronto office under hybrid work model. Demonstrated thoroughness, accuracy and attention to detail in claim reviews and data capture. Strong analytical and inquisitive skills. Excellent attention to meeting time service and achieving deliverables. High degree of self‑motivation, continuing development and proven ability to work independently. Demonstrated desire and aptitude to learn multiple lines of business and claim types. Excellent presentation and report creation and delivery skills, strong verbal and written communication skills. Demonstrated ability to build solid client relationships. Knowledge of Underwriting concepts and medical terminology is an asset. Power BI and related coding skills is an asset. Limited travel within Canada is expected. What Can We Offer You? An engaging and collaborative environment that promotes continuous learning and development A hybrid work environment that combines weekly in‑office and remote days A great compensation package including annual company bonus Market leading company‑paid flexible health and dental benefits, starting on your first day Flexible dollars provided by the company to put towards Health Spending Account and/or Wellness Spending Account Immediate participation in DC Pension Plan with an automatic employer contribution, plus optional company match Generous time off including vacation, personal days, unplanned time, statutory holidays and company‑wide early closure half‑days Learning and development programs and resources, including unlimited access to LinkedIn Learning, Education Assistance Program and reimbursement for professional fees Maternity, Parental & Adoption Leave top‑up program Employee Referral Program, Recognition & Rewards Platform Our base salary range for this role is between $112,670 and $130,460 per year, plus an opportunity for an annual company bonus based upon a percentage of eligible pay. The salary estimate displayed represents the typical salary range for candidates hired in this position. Factors that may be used to determine your actual salary include your specific skills, how many years of experience you have and comparison to internal equity. This role is located in our Toronto office on 390 Bay St , and we operate in a hybrid work model . This job posting is for an existing vacancy. Munich Re is committed to providing a work environment that is inclusive and free of employment barriers and discrimination. Accommodations will be made for qualified applicants with a disability throughout the recruitment process. If you receive a request for an interview and you have a disability which will require an accommodation to support your participation, please contact as soon as practical so that suitable accommodations can be arranged. #J-18808-Ljbffr