Accident Benefit Adjuster

2 weeks ago

Burlington, Ontario, Canada The Co-operators Full time

Position Overview:

Company:
CUMIS Union

Number of Positions: 1

Language:
This role operates in English.

Work Model:
Hybrid

Alternate Title:
n/a

Additional Information:

This is a 12 month temporary/contract position.

Union Eligible Phase:
Feb 8,9,10

Union Ineligible Phase:
Feb 13

The Opportunity:


We are a leading Canadian financial services co-operative committed to being a catalyst for a sustainable and resilient society and our team is essential to deliver on this strategy.

That's why we prioritize our people, to ensure we provide a strong culture and development opportunities which enables our team to thrive and to live our purpose.

The best part is that you will work with people that care passionately about you, our clients, and our communities.

The core function of the position is to adjudicate accident benefit injury claims. This position requires investigation and facilitation of assigned claims reported, in accordance with the Company and Regulatory guidelines. In this role, the adjuster is accountable for making claims decisions for medical and/or attendant care and/or disability benefits.

The majority of this function involves interacting with policyholders and service providers and providing direction to independent adjusters, defense counsel, medical experts, etc.

in order to deliver the claims service and make claims decisions within their assigned authority.

How you will create impact:

  • Investigate, interpret coverage, reserve adequately, negotiate and settle automobile accident benefit claims in accordance with the Ontario Statutory Accident Benefits Schedule, or Section B policies for Alberta, Nova Scotia, New Brunswick, Newfoundland.
  • Providing quality client service in accordance with claims handling standards and within government related timelines.
  • Actively participate with claimants, physicians, treatment providers, employers, rehabilitation workers and other service providers in the development, approval, implementation and monitoring of appropriate case management plans for clients.
  • Prepare written correspondence to claimant regarding claim decision with specific reference to applicable legislation.
  • Authorize payments and reserves up to $25,000 authority.
  • Effectively negotiate and settle claims to their conclusion either through settlement meetings, mediation or otherwise.
  • Prevent fraudulent or overstated claims by investigating discrepancies in claim information.
  • Responsible for working knowledge of policy management system, Microsoft Word, Excel.

How you will succeed:

  • You adapt to change and are committed to continuous improvement, in order to exceed client expectations.
  • Your strong communication skills allow you to clearly convey messages.
  • You're an effective team player who shares knowledge to support your peers.

To join our team:

  • Postsecondary education
  • University or College.
  • Strong knowledge of insurance policy wording, legislation and regulations.
  • Completion of 3 CIP courses, preferably C11 Principles and Practices.
  • 13 years successful related claims handling experience in property and casualty claims and/or relevant experience in the property and casualty litigation field.

Interested in applying?:


Co-operators is focused on fostering an inclusive, equitable and accessible work environment and we encourage individuals from all identity groups to apply.

If you require an accommodation during the recruitment process, please contact the hiring manager.

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