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Insurance Claims Adjuster
1 month ago
Job Overview
The Claims Adjuster 3, Casualty (CGL Non-Auto) plays a crucial 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 claim's lifecycle. The Claims Adjuster 3 is accountable for providing timely service and prompt management of claims pending from initial report to conclusion.
Key Responsibilities
- Conduct thorough and fair liability, coverage, and quantum investigations to provide the best defense for members.
- Ensure timely and proactive communication with members, stakeholders, and vendors through voice-to-voice, digital, and written correspondence.
- Adjust complex casualty claims, including those involving high-value losses and intricate liability issues.
- Review and interpret policy wordings to determine policy coverage and communicate coverage decisions to members.
- Establish timely and accurate loss and expense reserves throughout the claim's lifecycle by evaluating relevant information from various sources.
- Conduct comprehensive investigations to determine coverages and liability, adhering to Wawanesa's adjusting guidelines and recognizing when to engage 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 outcome for members. Manage claims in litigation, mediation, or arbitration, providing 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, 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.
Qualifications
- Exceptional customer service skills, demonstrating empathy and concern for member satisfaction.
- 5-10 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 reaching the proper licensing requirements.
- Excellent knowledge of medical and legal terminology.
- Excellent communication skills, including listening, written, and spoken.
- Excellent investigative and analytical skills, 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.
About Wawanesa Insurance
Wawanesa Insurance is a leading provider of insurance solutions in Canada, recognized for its commitment to delivering exceptional service and value to its customers. As an equal opportunity employer, Wawanesa is dedicated to fostering a diverse and inclusive workforce that reflects the communities it serves.