Claims Adjuster, Accident Benefit

2 weeks ago

Toronto, Canada Onlia Full time

**Onlia’s mission: Bring clarity to Insurance**

Onlia offers innovative digital insurance and a telematics app that incentivises good driving to the Ontario market. Onlia’s mission is to bring clarity to insurance and simplify consumer’s relationship with their insurance company through a digital experience, and best in class customer service. Launched in 2018, Onlia is a joint venture between Achmea, the largest insurance group of the Netherlands, and Fairfax Financial, a Canadian-based financial holding company.

We are here to disrupt insurance in Ontario and are building a team of heavy hitters to make that a reality. We work collaboratively in a fast-paced and agile environment. Every member of our team is empowered to take ownership of their role, and to assist in the build of a best-in-class experience for our customers.

As the Claims Adjuster, Accident Benefit you are responsible for providing efficient and prompt investigation, evaluation, negotiation, and settlement of minor or moderate size complex claims in accordance with corporate guidelines and best practices. If this sounds like you, keep reading

**Key Accountabilities**:
**KA 1** Investigate, confirm coverage, negotiate settlements, and conduct reporting and documentation of claims of minor to moderate size complexity in accordance with established guidelines.

**KA 2** Review available information and establish, maintain, and recommend appropriate reserve, payment or recovery, negotiation, or declination. Enter and record claims, reserves, and payments as well ensure reserve adequacy throughout the life of the claim file as per company guidelines. Process all payments promptly within guidelines and policy/statutory requirements.

**KA 3** Prepare summaries and files for litigation, mediation/arbitration, and multidisciplinary assessments. Direct activities of defence counsel to ensure an appropriate resolution. Attend and

participate in meetings, mediations, arbitrations, settlement conferences.

**KA 5** Develop relationships with other departments such as underwriting in order to meet business goals. Assist Manager with preparing/completing monthly statistical reports.

**KA 7 ** Participate in the training and development seminars, and provide technical expertise and advice regarding products, systems, and processes. Provide direction to support staff on data input into the claims system.

**Key Indicators of Success**:

- Ability to understand and interpret insurance contracts and changes in the interpretation as a result of case law.
- Ability to demonstrate patience, empathy and understanding in dealings with customers.
- Ability to provide prompt, efficient, and courteous service to all parties involved.
- Ability to assess liability and understand case law developments in the jurisdiction.
- Demonstrated negotiation skills.
- Strong analytical, problem-solving skills, investigative, and decision-making skills.
- Demonstrated report-writing skills, including an orientation toward detail and precision.
- Able to plan, organize, and manage multiple demands and changing priorities.
- Demonstrated ability to work well as a team player or independent contributor; Self-motivated.
- Strong leadership skills and interpersonal skills.
- Excellent communication (both oral and written) skills to explain processes and terms.

**Qualifications**:

- Post-secondary education and / or equivalent on the job experience
- Minimum 1-3 years Claims adjusting experience.
- Working knowledge of principles and practices related to claims settlement, policy wordings, insurance contracts, fraud investigations and coverage questions.
- Actively pursuing CIP/FCIP designation an asset.

**WORKING AT ONLIA**

Our aim is to create a workforce that is diverse, promotes positivity, and demonstrates the values of equality, fairness, and respect in everything we do. We are dedicated to an anti-discrimination approach and provide equal opportunity for employment and advancement throughout Onlia regardless of gender, race, ethnicity, national origin, age, sexual orientation or identity, education, or disability. We respect and value diverse life experiences and cultures and ensure that all voices are valued and heard.

**Salary**: $60,000.00-$67,000.00 per year

Schedule:

- 8 hour shift
- Monday to Friday

Application question(s):

- Do you have a minimum of 1-3 years of claims adjusting experience examining claims?
- Are you actively pursuing CIP or FCIP designation?

Work Location: Hybrid remote in Toronto, ON M5A 0L6

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