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Auto Bodily Injury Claims Specialist

2 months ago

Calgary, Alberta, Canada 570 The Dominion of Canada General Full time
Job Title: Auto Bodily Injury Senior Technical Specialist

At 570 The Dominion of Canada General, we are seeking a highly skilled Auto Bodily Injury Senior Technical Specialist to join our team.

Job Summary:

The Auto Bodily Injury Senior Technical Specialist will be responsible for investigating, evaluating, reserving, negotiating, and resolving assigned claims in accordance with Best Practices.

Key Responsibilities:

  • Directly handle assigned severe claims.
  • Provide quality customer service and ensure file quality timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case.
  • Consult with Manager on use of Claim Coverage Counsel as needed.
  • Directly investigate each ABI claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers, and technical experts to determine the extent of liability, damages, and contribution potential.
  • Interview witnesses and stakeholders; take necessary statements, as strategically appropriate.
  • Complete outside investigation as needed per case specifics.
  • Actively engage in the identification, selection, and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subro, Risk Control, nurse consultants, fraud investigators, and other experts.
  • Verify the nature and extent of injury or damage by obtaining and reviewing appropriate records and damages documentation.
  • Maintain claim files and document claim file activities in accordance with established procedures Utilize evaluation documentation tools in accordance with department guidelines.
  • Proactively review CFAs for adherence to quality standards and trend analysis.
  • Utilize diary management to ensure that all claims are handled timely.
  • At required time intervals, evaluate liability & and ensure damages exposure.
  • Establish and maintain proper indemnity & expense reserves.
  • Recommend appropriate cases for discussion at roundtable.
  • Attend and/or present at roundtables/ authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expense.
  • Actively and enthusiastically share experience and knowledge of creative resolution techniques to improve the claim results of others.
  • Apply the Company's claim quality management protocols, Best Practices, and metrics to all claims; document the rationale for any departure from applicable protocols and metrics with or without assistance.
  • 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.
  • Manages litigated claims.
  • Develop litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers.
  • 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 both allocated and unallocated loss adjustment expenses.
  • Attend depositions, mediations, arbitrations, pre-trials, trials, and all other legal proceedings, as needed.
  • Update appropriate parties as needed, providing new facts as they become available, and their impact upon the liability analysis and settlement options.
  • Recognize cases, based on severity/complexity protocols that should be transferred to another level of claim professional and refer on a timely basis.
  • Appropriately deal with information that is considered personal and confidential.
  • Fulfill specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC) instructions, and inquires from agents and brokers.
  • Represent the company as a technical resource, attend legal proceedings as needed, act within established professional guidelines as well as applicable laws.
  • Actively provide mentoring and coaching to less experienced claim professionals to increase the technical expertise and improve bench strength.
  • Share accountability with business partners to achieve and sustain quality results.
  • Evaluate all claims for recovery potential; directly handle recovery efforts and/or engage and direct Company resources for recovery efforts.
  • Perform other duties as assigned.