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Casualty Claims Adjuster

2 months ago

Toronto, Ontario, Canada Wawanesa Insurance Full time

Job Overview

The Claims Adjuster 2, Casualty role at Wawanesa Insurance contributes to the company's goal of delivering an exceptional and consistent claims experience through proactive and fair investigation, evaluation, negotiation, and settlement of moderate to high casualty claims. This position is responsible for applying and explaining policy coverages and documenting claim files throughout the life of a claim. The role is accountable for providing timely service and prompt management of claims pending from initial report to conclusion.

Key Responsibilities

  • Provide a strong defense for policyholders through proactive, fair, and thorough liability, coverage, and quantum investigation.
  • Timely and proactive communication, through voice to voice, digital, and written correspondence, ensuring that all inquiries are effectively dealt with in a timely and professional manner.
  • Adjustment of casualty claims of moderate to high complexity.
  • Review and interpret policy wordings, determine policy coverage, and communicate coverage decisions to policyholders.
  • Establish timely and accurate loss and expense reserves throughout the life of the claim through evaluation of relevant information from various sources such as independent adjusters, medical, legal, financial, and vocational.
  • Ensure a comprehensive investigation is conducted on all files to determine coverages and liability, while adhering to Wawanesa's adjusting guidelines, and recognizing when to engage appropriate internal and external resources.
  • Coordinate and manage services with vendors and service providers such as lawyers, engineers, accountants, and health practitioners.
  • Negotiate with claimants, lawyers, and other insurers to resolve claims at the best possible result for policyholders. Manage claims in litigation, mediation, or arbitration. Provide instruction to assigned counsel.
  • Maintain an effective and current diary system and document claim file activities in accordance with established procedures.
  • Demonstrate and maintain knowledge and understanding of policy coverages, while complying with regional regulatory and licensing requirements (as applicable). Remain current with legislative changes and trends in the insurance industry.
  • Occasionally participate in private mediation, court proceedings, and other dispute resolution as required.
  • Contribute to employee development through training, technical guidance, and coaching.
  • Perform other duties as assigned.

Requirements

  • Exceptional customer service skills demonstrating empathy and concern for policyholder satisfaction.
  • 5 years of insurance adjusting experience or equivalent.
  • Post-secondary degree is preferred.
  • Willingness to work toward Chartered Insurance Professional (CIP) designation and where required, dedicated to reach the proper licensing requirements.
  • Comprehensive knowledge of medical and legal terminology.
  • Excellent communication skills; listening, written, and spoken.
  • Excellent investigative and analytical skills. Detail oriented with a high degree of accuracy regarding data entry.
  • Excellent time management and organizational skills with the ability to prioritize work in a fast-paced, changing environment.
  • Excellent negotiation, decision-making, and critical thinking skills.
  • Strong teamwork skills with the ability to collaborate with others.