Lead Casualty Claims Specialist
3 weeks ago
Job Overview
The Lead Casualty Claims Specialist plays a vital role in achieving Wawanesa's mission of providing a superior and consistent claims experience. This position involves thorough and equitable investigation, assessment, negotiation, and resolution of complex and significant casualty claims. The specialist is tasked with interpreting and clarifying policy coverages while meticulously documenting claim files throughout the claim process. This role is essential in ensuring timely service and effective management of claims from the initial report to final resolution.
Key Responsibilities
Deliver exceptional support for members through proactive, equitable, and comprehensive liability, coverage, and quantum investigations. Maintain timely and proactive communication through various channels, ensuring all inquiries are addressed professionally and promptly. Manage high complexity and significant loss casualty claims. Analyze and interpret policy language, determine coverage applicability, and communicate coverage decisions to members. Establish accurate loss and expense reserves throughout the claim lifecycle by evaluating relevant information from diverse sources, including independent adjusters, medical professionals, legal advisors, and financial experts. Conduct thorough investigations on all claims to ascertain coverages and liabilities, adhering to Wawanesa's adjusting standards and recognizing when to involve appropriate internal and external resources. Coordinate and oversee services with vendors and service providers, including legal counsel, engineers, accountants, and healthcare practitioners. Negotiate with claimants, legal representatives, and other insurers to achieve optimal resolutions 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 claim file activities in accordance with established protocols. Demonstrate and uphold knowledge of policy coverages while complying with regional regulatory and licensing standards (as applicable). 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
Outstanding customer service abilities, showcasing empathy and commitment to member satisfaction. Minimum of 5 years of experience in insurance adjusting or a related field. A post-secondary degree is preferred. Willingness to pursue Chartered Insurance Professional (CIP) designation and, where necessary, commitment to fulfilling licensing requirements. Strong understanding of medical and legal terminology. Excellent communication skills, including listening, writing, and speaking. Strong investigative and analytical capabilities. Detail-oriented with a high level of accuracy in data entry. Exceptional time management and organizational skills, with the ability to prioritize tasks in a dynamic environment. Proficient negotiation, decision-making, and critical thinking skills. Strong teamwork abilities, fostering collaboration with colleagues. Diversity, Equity, Inclusion & Belonging
Wawanesa is an equal opportunity employer committed to cultivating 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 needs are available upon request throughout all aspects of the recruitment and selection process.
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