Senior Claims Specialist
2 months ago
We are seeking a highly skilled Senior Claims Specialist to join our team at 570 The Dominion of Canada General. As a key member of our claims department, you will be responsible for investigating, evaluating, and resolving complex auto bodily injury claims in accordance with our Best Practices.
Key Responsibilities- Directly handle assigned severe claims, providing quality customer service and ensuring timely coverage analysis and communication with insureds.
- Consult with Manager on the use of Claim Coverage Counsel as needed.
- Investigate each ABI claim through prompt and strategically-appropriate contact with policyholders, claimants, and other stakeholders to determine liability, damages, and contribution potential.
- Actively engage in the identification, selection, and direction of internal and external resources for specific activities required to evaluate claims.
- Verify the nature and extent of injury or damage by obtaining and reviewing records and damages documentation.
- Maintain claim files and document claim file activities in accordance with established procedures.
- Proactively review CFAs for adherence to quality standards and trend analysis.
- Utilize diary management to ensure timely handling of claims.
- Evaluate liability and damages exposure, establishing and maintaining proper indemnity and expense reserves.
- Recommend cases for discussion at roundtable and attend/present at roundtables/authority discussions for collaboration of technical expertise.
- Actively share experience and knowledge of creative resolution techniques to improve claim results.
- Apply claim quality management protocols, Best Practices, and metrics to all claims, documenting rationale for any departures.
- Develop and employ creative resolution strategies.
- Responsible for prompt and proper disposition of all claims within delegated authority.
- Negotiate disposition of claims with insureds and claimants or their legal representatives.
- Recognize and implement alternate means of resolution.
- Manage litigated claims, developing litigation plans with staff or panel counsel, including discovery and legal expenses.
- Apply litigation management through the selection of counsel, evaluation, and direction of claim and litigation strategy.
- Track and control legal expenses to assure cost-effective resolution.
- Effectively and efficiently manage allocated and unallocated loss adjustment expenses.
- Attend depositions, mediations, arbitrations, pre-trials, trials, and other legal proceedings as needed.
- Update parties as needed, providing new facts and their impact on liability analysis and settlement options.
- Recognize cases for transfer to another level of claim professional and refer on a timely basis.
- Deal with personal and confidential information appropriately.
- Fulfill specific service commitments made to certain accounts, as outlined in SAC instructions, and inquires from agents and brokers.
- Represent the company as a technical resource, attending legal proceedings as needed, acting within established professional guidelines and applicable laws.
- Provide mentoring and coaching to less experienced claim professionals to increase technical expertise and improve bench strength.
- Share accountability with business partners to achieve and sustain quality results.
- Evaluate all claims for recovery potential, directly handling recovery efforts and/or engaging and directing Company resources.
- Perform other duties as assigned.
- University/College Degree or equivalent in business experience, preferred.
- Comprehensive working-level knowledge and skill in various business line products.
- Strong negotiation and customer service skills.
- Extensive claim and/or legal experience and technical expertise to evaluate severe and complex claims.
- Able to make independent decisions on most assigned cases without involvement of supervisor.
- Openness to ideas and expertise of others, actively soliciting input and sharing ideas.
- Thorough understanding of commercial lines products, policy language, exclusions, ISO forms, and effective claims handling practices.
- Demonstrated coaching, influence, and persuasion skills.
- Advanced written and verbal communication skills to understand, synthesize, interpret, and convey complex data and information to audiences with varying levels of expertise.
- Ability to adapt to and support cultural change.
- Strong technology aptitude, using business technology tools to research, track, and communicate information.
- State insurance adjusting license (where applicable) and ongoing satisfaction of any necessary continuing education requirements.
- In order to perform the essential job functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with provincial and Travelers requirements.
- Health Insurance: Employees and their eligible family members are eligible for coverage from the first day of employment.
- Retirement: Travelers provides a core contribution of 3% of your total eligible earnings to your Deferred Profit Sharing Plan.
- Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus the opportunity to purchase additional days to allow for up to a total of 36 PTO days per year.
- Wellness Program: The Travelers wellness program is comprised of tools, discounts, and resources that empower you to achieve your wellness goals and caregiving needs.
- Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved.
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