Claims Adjuster

2 months ago


Moncton, New Brunswick, Canada Wawanesa Insurance Full time
Job Overview

The Claims Adjuster 3, Casualty plays a critical role in delivering an exceptional and consistent claims experience through proactive and fair investigation, evaluation, negotiation, and settlement of high complexity and large loss casualty claims. This role is responsible for applying and explaining policy coverages and documenting claim files throughout the life of a claim. The position is accountable for providing timely service and prompt management of claims pending from initial report to conclusion.

Key Responsibilities
  1. Conduct thorough and proactive liability, coverage, and quantum investigations to provide the best defense for members.
  2. Ensure timely and effective communication with members, claimants, and other stakeholders through voice, digital, and written correspondence.
  3. Adjust casualty claims of high complexity and large loss, ensuring accurate and timely loss and expense reserves.
  4. Review and interpret policy wordings, determine policy coverage, and communicate coverage decisions to members.
  5. Conduct comprehensive investigations to determine coverages and liability, adhering to Wawanesa's adjusting guidelines and engaging internal and external resources as needed.
  6. Coordinate and manage services with vendors and service providers, such as lawyers, engineers, accountants, and health practitioners.
  7. Negotiate with claimants, lawyers, and other insurers to resolve claims at the best possible result for members.
  8. Maintain an effective and current diary system and document claim file activities in accordance with established procedures.
  9. Demonstrate and maintain knowledge and understanding of policy coverages, complying with regional regulatory and licensing requirements.
  10. Occasionally participate in private mediation, court proceedings, and other dispute resolution as required.
  11. Contribute to employee development through training, technical guidance, and coaching.
Qualifications
  1. Exceptional customer service skills, demonstrating empathy and concern for member satisfaction.
  2. 5 years of insurance adjusting experience or equivalent.
  3. Post-secondary degree is preferred.
  4. Willingness to work toward Chartered Insurance Professional (CIP) designation and where required, dedicated to reach the proper licensing requirements.
  5. Excellent knowledge of medical and legal terminology.
  6. Excellent communication skills, including listening, written, and spoken.
  7. Excellent investigative and analytical skills, with a high degree of accuracy regarding data entry.
  8. Excellent time management and organizational skills, with the ability to prioritize work in a fast-paced, changing environment.
  9. Excellent negotiation, decision-making, and critical thinking skills.
  10. Strong teamwork skills, with the ability to collaborate with others.

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