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Claim Technical Specialist

1 month ago


Cambridge ON, Canada GORE MUTUAL INSURANCE COMPANY Full time

Fueled by investments in talent and technology, our bold strategy to transform is nearly complete. Now, we're proudly building on that legacy to transform our company—and our industry—for the better.
Our path forward sharpens our focus on business performance, driven by leading technology, innovation and an agile, high-performing culture. With Gore Mutual and Beneva announcing their intent to merge in 2026, we'll be uniting two well-established, financially strong, and trusted brands to become the strongest mutual insurer in Canada, ensuring Canadians have purpose-driven insurance options for generations to come. Claims Technical Specialist, APD
The Claims Technical Specialist plays a pivotal role in enhancing claims efficiency and managing complex cases. This position requires a blend of technical expertise, leadership and mentorship, ensuring high standards of claim handling while supporting team development. Investigate and identify subrogation opportunities within claims.
Collaborate with legal teams and external parties to recover losses.
Analyze policy details, accident reports, and evidence to determine liability.
SIU (Special Investigations Unit) Management:
Handle claims referred to the SIU for potential fraud or suspicious activity.
Prioritize and handle sensitive information while acting as the point of contact between SIU, the customer and the broker.
Participate and handle escalation/complaint calls from customers, brokers, vendors, and others coming to a fair resolution abiding with the Ontario Automobile Policy (OAP-1) and company policies.
Employee Claims Management:
Assist employees with their claims, ensuring timely processing and fair settlements.
Provide guidance on documentation requirements and claims procedures.
Display strong work ethics while dealing with private and sensitive employee data
Coaching and Mentoring:
Support junior Adjusters by sharing knowledge and best practices.
Provide constructive feedback on claim assessments and negotiation strategies.
5 years of prior Auto Physical Damage Claims Adjusting experience.
~Experience handling Subrogation claims.
~ Experience handling SIU claims.
~ Proven ability to handle complex claims.
~ Coaching and mentoring.
~ Litigation Management.
~ Experience in handling Auto claims.

Gore Mutual Insurance Company is committed to providing accommodations for people with disabilities during all phases of the recruiting process, including the application process.
If you require accommodation because of a disability, we will work with you to meet your needs. Contact us and a human resources representative will consult with you to determine an appropriate accommodation.