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Casualty Claims Specialist
3 months ago
Job Overview
The Casualty Claims Specialist at Wawanesa Insurance plays a vital role in achieving our commitment to providing an outstanding and consistent claims experience. This position involves thorough investigation, assessment, negotiation, and resolution of moderate to high complexity casualty claims. The specialist is responsible for interpreting policy coverages and maintaining detailed documentation throughout the claims process. Timely service and effective management of claims from initial report to resolution are key responsibilities of this role.
Key Responsibilities
Deliver exceptional service to members through diligent, fair, and comprehensive liability, coverage, and quantum investigations. Ensure proactive communication through various channels, including voice, digital, and written correspondence, addressing all inquiries in a professional and timely manner. Manage the adjustment of casualty claims with moderate to high complexity. Analyze and interpret policy documents, ascertain coverage, and communicate decisions effectively to members. Establish accurate 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 determine coverage and liability, adhering to Wawanesa's adjusting guidelines and engaging necessary internal and external resources when required. Coordinate services with external vendors and service providers, including legal professionals, engineers, accountants, and healthcare practitioners. Negotiate settlements with claimants, legal representatives, and other insurers to achieve optimal outcomes for our members. Manage claims that are in litigation, mediation, or arbitration, providing guidance to assigned legal counsel. Maintain an organized and current diary system, documenting all claim file activities in accordance with established protocols. Demonstrate and uphold a strong understanding of policy coverages while complying with regional regulatory and licensing standards. Stay informed about 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 assigned.Qualifications
Exceptional customer service abilities, showcasing empathy and a commitment to member satisfaction. A minimum of 5 years of experience in insurance adjusting or a related field. A post-secondary degree is preferred. Willingness to pursue the Chartered Insurance Professional (CIP) designation and meet necessary licensing requirements. Comprehensive understanding of medical and legal terminology. Strong communication skills, both written and verbal, with effective listening abilities. Excellent investigative and analytical capabilities, with a keen attention to detail in data entry. Outstanding time management and organizational skills, with the ability to prioritize tasks in a dynamic environment. Strong negotiation, decision-making, and critical thinking skills. Ability to work collaboratively and effectively within a team environment.Wawanesa is proud to be recognized as one of the leading employers in Canada, offering an exceptional workplace culture.
Diversity, Equity, Inclusion & Belonging
Wawanesa is an equal opportunity employer dedicated 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 any individual's protected status. Accommodations related to disability or medical conditions are available upon request throughout the recruitment and selection process.
