Claims Adjuster 3

4 weeks ago

Kitchener, Ontario, Canada Wawanesa Insurance Full time

Job Overview

The Claims Adjuster 3, Casualty (Commercial General Liability / General Liability) 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 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 proactive liability, coverage, and quantum investigations to provide the best defense for members.
  • Ensure timely and effective communication with members, claimants, and other stakeholders through voice, digital, and written correspondence.
  • Adjust casualty claims of high complexity and large loss, applying advanced knowledge of policy coverages and regulatory requirements.
  • Review and interpret policy wordings, determine policy coverage, and communicate coverage decisions to members.
  • Establish timely and accurate loss and expense reserves throughout the life of the claim through evaluation of 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 result for members.
  • 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.
  • Participate in private mediation, court proceedings, and other dispute resolution as required.
  • Contribute to employee development through training, technical guidance, and coaching.

Qualifications

  • 5 years of insurance adjusting experience or equivalent, with advanced knowledge of Commercial General Liability and Personal Liability Claims.
  • Post-secondary degree is preferred.
  • Willingness to work toward Chartered Insurance Professional (CIP) designation and where required, dedicated to reach the proper licensing requirements.
  • Excellent 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.
  • Exceptional customer service skills demonstrating empathy and concern for member satisfaction.
  • Exposure to the Guidewire Insurance Suite Products is an asset.

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