Lead Casualty Claims Specialist
3 weeks ago
Job Overview
The Lead Casualty Claims Specialist plays a pivotal role in Wawanesa's mission to provide a superior and consistent claims experience. This position involves thorough and equitable investigation, assessment, negotiation, and resolution of complex and substantial casualty claims. The specialist is tasked with interpreting and clarifying policy coverages while meticulously documenting the claims process from initiation to resolution.
Key Responsibilities
Deliver exceptional advocacy for members through diligent, fair, and comprehensive investigations into liability, coverage, and damages. Ensure timely and proactive communication through various channels, including verbal, digital, and written formats, addressing all inquiries with professionalism. Manage high-stakes casualty claims with significant complexity and loss. Analyze and interpret policy language, determine coverage applicability, and communicate decisions effectively to members. Establish accurate and timely loss and expense reserves throughout the claims lifecycle by evaluating information from diverse sources, including independent adjusters, medical professionals, legal advisors, and financial experts. Conduct thorough investigations on all claims to ascertain coverage and liability, adhering to Wawanesa's guidelines and recognizing when to involve appropriate internal and external resources. Coordinate and oversee services with external vendors and service providers, including legal counsel, engineers, accountants, and healthcare professionals. Negotiate with claimants, legal representatives, and other insurers to achieve optimal resolutions for our members. Manage claims in litigation, mediation, or arbitration, providing direction to assigned legal counsel. Maintain an organized and current diary system, documenting all claim file activities in accordance with established protocols. Exhibit and uphold knowledge of policy coverages while complying with regional regulatory and licensing standards. Stay informed on legislative changes and trends within the insurance sector. Occasionally participate in private mediations, court proceedings, and other dispute resolution processes as necessary. Contribute to the development of team members through training, technical support, and mentorship. Perform additional duties as required.Qualifications
Outstanding customer service abilities, demonstrating empathy and a commitment to member satisfaction. Minimum of 5 years of experience in insurance adjusting or equivalent expertise. A post-secondary degree is preferred. Commitment to pursuing the Chartered Insurance Professional (CIP) designation and fulfilling necessary licensing requirements. Strong understanding of medical and legal terminology. Excellent communication skills, encompassing listening, writing, and speaking. Exceptional investigative and analytical capabilities, with meticulous attention to detail in data entry. Strong time management and organizational skills, with the ability to prioritize tasks in a dynamic environment. Proficient negotiation, decision-making, and critical thinking skills. Effective teamwork abilities, with a collaborative approach to working with others.#LI-HYBRID #LI-LR1
Wawanesa is proud to be recognized as one of the top employers in Canada, offering an exceptional workplace environment.Diversity, Equity, Inclusion & Belonging
Wawanesa is an equal opportunity employer committed to fostering a diverse workforce that is equitable and inclusive for all. We provide equal employment opportunities to all employees and applicants without regard to an individual's protected status. Accommodations related to disability or medical conditions are available upon request throughout all aspects of the recruitment and selection process.
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