Christina Schulte
Toronto,ON
Summary
Dedicated and adaptable professional with a proactive attitude and the ability to learn quickly. Strong work ethic and effective communication skills. Eager to contribute to a dynamic team and support organizational goals.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Claims Advisor
TD Insurance
Toronto, Ontario
05.2020 - Current
- Processed incoming mail, emails and telephone calls relating to claims.
- Advised claimants on the best course of action based on policies and procedures.
- Provided advice on the claims process, including policy coverage and benefits.
- Researched complex cases using appropriate resources.
- Drafted correspondence for customers regarding their claim status or decisions made about their claim.
- Assessed claims to determine eligibility and verify accuracy of information provided by customers.
- Investigated, analysed and resolved customer complaints regarding claims.
- Prepared detailed reports on claim investigations, decisions and outcomes for management review.
- Determined liability, compensability, and benefits due on each claim.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
- Verified liability extent with reviews of police reports, medical treatment histories and other records.
- Investigated potentially fraudulent claims with focus on thoroughness, quality, and cost control.
- Input claim information and payments into company database.
Universal Claim Advisor
TD Insurance
Toronto, Ontario
01.2019 - 05.2020
- Maintained accurate records of all activities related to each claim including notes from conversations with claimants, witnesses, appraisers.
- Analyzed police reports, medical records, witness statements, photographs, and other evidence to determine claim validity.
- Communicated regularly with clients via telephone or email regarding their total loss claims.
- Investigated and documented liability, coverage, and damages related to total loss claims.
- Reviewed estimates prepared by appraisers or auto body shops regarding the cost of repairs to vehicles involved in total loss claims.
- Negotiated settlements between claimants and insurers while ensuring fair compensation was provided in a timely manner.
- Interviewed and spoke with specialists, witnesses, agents and claimants to record incident information.
- Utilized claims software and databases for tracking and managing active claims.
- Analyzed claim trends to identify potential fraud and took appropriate investigative actions.
- Reviewed and interpreted police reports and witness statements to establish facts of claims.
- Provided exceptional customer service, addressing concerns and questions promptly.
- Investigated auto accident claims to determine liability and coverage.
- Evaluated claims for possible fraud, contacting appropriate department for assistance and further investigation.
- Managed heavy workload of ongoing cases thanks to strong organizational, time management, and collaboration skills.
Claims Adjuster
TD Insurance
Torototo, Ontario
09.2016 - 01.2019
Senior Claims Adjudicator, Investments
Empire Life
Kingston, Ontario
12.2015 - 08.2016
Intermediate Claims Adjudicator
Empire Life
Kingston, Ontario
08.2001 - 12.2015
- Reviewed and evaluated applications for life insurance policies to determine risk factors.
- Reviewed customer claims, identified discrepancies and determined appropriate course of action.
- Verified documents to ensure accuracy of information provided by customers.
- Assessed medical records for coverage eligibility and benefit accuracy.
- Investigated fraudulent claims by gathering evidence from various sources.
- Interpreted policy provisions to determine the extent of the company's liability.
- Communicated with policyholders to explain claims processes, coverage, and decisions.
- Assisted in the development and implementation of claims procedures to improve efficiency.
- Conducted training sessions for new hires on claims processing and company protocols.
- Reviewed and processed insurance claims following company procedures and industry regulations.
- Gathered proper documentation and data to prepare claims for submission.
- Supported policyholders through the claims process, providing exceptional customer service.
- Investigated potentially fraudulent claims with focus on thoroughness, quality, and cost control.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
Skills
- Policy Interpretation
- Insurance knowledge
- Claims Investigation
- Claims Processing
- Claims Evaluation
- File and Record Management
- Coverage Assessment
- Relationship Building
- Decision-Making
- Client Interviewing
- Policy investigations
- Team Collaboration
- Active Listening
- Critical Thinking
- Organizational Skills
- Policy analysis
- Analytical Thinking
- Problem-Solving
- Effective Communication
- Professionalism
- Fraud identification
- Attention to Detail
- Analytical Skills
- Written Communication
- Interpersonal Communication
- Time management abilities
- Problem-solving abilities
- Insurance fraud expertise
- Human relations
- Excellent Communication
Certification
- Associate of Life and Health Claims (ALHC)
- Associate Customer Service (ACS)
Timeline
Claims Advisor
TD Insurance
05.2020 - Current
Universal Claim Advisor
TD Insurance
01.2019 - 05.2020
Claims Adjuster
TD Insurance
09.2016 - 01.2019
Senior Claims Adjudicator, Investments
Empire Life
12.2015 - 08.2016
Intermediate Claims Adjudicator
Empire Life
08.2001 - 12.2015
- Associate of Life and Health Claims (ALHC)
- Associate Customer Service (ACS)
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