Clinical Claim Assessor Clinical Claim Assessor …

Canada Life Limited
in Bristol, England, United Kingdom
Permanent, Full time
Be the first to apply
Canada Life Limited
in Bristol, England, United Kingdom
Permanent, Full time
Be the first to apply
Canada Life UK looks after the retirement, investment and protection needs of individuals, families and companies. We help to build better futures for our customers, our intermediaries and our employees by operating as a modern, agile and welcoming organisation.

Part of our parent company Great-West Lifeco, Canada Life UK has operated in the United Kingdom since 1903. We have hundreds of respected and supported employees committed to doing the right thing for our customers and colleagues.

Canada Life UK is transforming to create a more customer-focused business by providing our customers with expertise on financial and tax planning, offering home finance and annuities propositions, and providing collective fund solutions to third party customers.

What we’re building 

We now need a Clinical Claim Assessor to support the transformation and the future growth of the business within the Group CMS function, so it can Provide security and peace of mind to our customers by offering protection, home finance and annuities propositions, and deliver great service and propositions that are valued by our customers.

Job summary

To deliver the best end to end Cancer and Clinical claim assessment service to Employers and Employees insured through the Group Critical Illness and Income Protection proposition

What you’ll do

  • Within authority levels, independently set up claims on the Group systems to accurately reflect the potential financial liabilities associated to Cancer and Clinical Health Claims.
  • Ensure escalation controls and checking procedures are followed for high benefit claims that exceed Groups’ financial retention limits or personal authority levels.
  • Follow company procedures to accurately check eligibility of claimants to ensure only those where a financial liability exists progress to full claim assessment.
  • Analyse and appraise all information received to understand validity of claims, including assessment of both medical and non-medical information against complex Policy Conditions.
  • Through analysis, identify missing or erroneous medical and non-medical information and where necessary seek clarity to ensure fair outcomes for customers and claimants and that all valid claims are paid as swiftly as possible.
  • For decline outcomes, ensuring evidence has been rigorously considered against Policy Terms and conditions and that broader consideration of fair outcomes and past FOS decisions are reflected in case notes.
  • Handle Personal Sensitive information in line with the company procedure and ensure the higher risks associated to medical information are carefully managed when liaising with the multiple parties involved in the claim process.
  • Demonstrate an engaging and outstanding level of customer service during claim assessment to ensure strategic distribution partners value our claim function as market leading, a key measure for IFAs in recommending Canada Life Health Claims proposition to new and existing customers
  • Ensure customer service skills accommodate the differing needs of corporate clients, recognising the needs of large segment FTSE 100 customers differ to a small and medium segment employers.  With appreciation of the effect the claim handling experience can have on the retention of all existing corporate health claim clients
  • Ensure all claim activity undertaken corresponds with Risk, Compliance and Legal guidelines and thorough audit trails reflect the highest levels of integrity required in a claims environment

Who you are


Demonstrates outstanding Customer Service skills to ensure distribution partners as well as large, medium and small segment corporate clients are more compelled to place new business and retain existing business with Canada Life

Strong telephone and written skills are essential and can demonstrate the desire to go the extra mile to meet all customer and stakeholder requirements


  • Strong attention to detail to ensure all relevant facts are identified to ensure fair and correct outcomes are reached in all claim decisions
  • Strong analytical skills to establish missing or erroneous information and has the wherewithal to seek clarity from the most appropriate source
  • High capability evident in following company procedure, essential to ensure consistent outcomes for claimants, regardless of the assessor appraising the claim evidence
  • Highly attuned to the Risk Culture and high levels of awareness with regard handling personal sensitive information in a claim environment
  • Demonstrates professionalism through own behaviours and actions


  • Uses all resources available to seek out the swiftest route to accurately verifying claims
  • Strives to improve processes for the benefit of customers, claimants and Canada Life
  • Positively responds to change and willing to work with the business to experiment on new approaches to claim handling
  • Some broader knowledge of Group and/or the health claims industry
  • In depth knowledge and understanding of the Policy Conditions associated to the IP and CIC products and how these are applied to Cancer and Clinical Health claims


  • Demonstrates desire to avoid unnecessary hand offs and owns all aspects of claims to reduce impact on colleagues and deliver better outcomes for customers
  • Shares knowledge with team colleagues and demonstrates willingness to support broader business and strategic goals
  • Flexibility evident to supports other teams depending on service standards and volumes of incoming work by team
  • Willing to cross skill to ensure consistent service standards can be maintained across function


  • GR1 preferable
  • Applicable licenses held preferable

What you’ll like about working here

As a Canada Life UK colleague, you’ll receive a competitive salary and comprehensive reward package including income protection, private medical insurance and life assurance, along with a generous pension and bonus scheme. You’ll also receive the support you need with your personal and professional development.

Our focus is to have an engaged, committed and motivated work force, operating in a high performing and collaborative culture. We want to create an organisation that offers opportunities for all our people to develop their skills and talent, and build rewarding careers with us.

Diversity and inclusion

Canada Life is committed to a diverse and inclusive workplace. Our role as an employer of choice is to provide the right environment for talented people to do their best work, by respecting, understanding and valuing individual differences.