Claims Specialist

4 weeks ago

Moncton, New Brunswick, Canada Wawanesa Insurance Full time

Job Overview

The Casualty Claims Specialist at Wawanesa Insurance plays a critical role in delivering an exceptional claims service experience through the fair and equitable adjustment of large to high complexity auto and/or non-auto bodily injury and property damage liability claims. This position is responsible for applying and explaining policy coverages and documenting claim files. The role is accountable for providing timely service and prompt management of claims from initial report to conclusion.

Key Responsibilities

  • Provide exceptional service to members throughout the claims process, demonstrating empathy and concern for their satisfaction.
  • Ensure timely and proactive communication with members, using various channels to effectively address their inquiries in a timely and professional manner.
  • Adjust property and casualty claims of large to high complexity, taking into account policy wordings and coverage decisions.
  • Review and interpret policy wordings, determine policy coverage, and communicate coverage decisions to members.
  • Establish timely and accurate loss and expense reserves through the life of the claim, evaluating and reconciling 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.
  • Collect evidence to support recovery efforts and coordinate investigations and services with vendors and service providers.
  • Negotiate and convey claim settlements within authority limits, communicating claim decisions promptly and effectively while delivering an exceptional member experience.
  • Maintain an effective diary system and document claim file activities in accordance with established procedures.
  • Demonstrate and maintain excellent knowledge and understanding of policy coverages, complying with regional regulatory and licensing requirements.
  • Stay current with legislative changes and trends in the insurance industry.
  • Understand Provincial and National Building Codes, as well as residential and commercial construction terminology, techniques, and best practices.
  • Maintain advanced knowledge of Provincial Legislative changes, arbitration decisions, and case law impacting Accident Benefits Claims.
  • Provide ongoing technical advice, guidance, peer coaching, and mentoring to claims staff.
  • Support CAT plans as necessary.

Qualifications

  • Exceptional customer service skills, demonstrating empathy and concern for member satisfaction.
  • Minimum 6 years of insurance adjusting experience, with strong knowledge of Commercial Lines Policy Wordings.
  • Post-secondary degree is preferred.
  • Chartered Insurance Professional (CIP), or working towards designation, and where required, dedicated to reaching the proper licensing requirements.
  • Exceptional knowledge of property estimating software, Xactware knowledge preferred.
  • Ability to interpret and quantify property damage estimates.
  • Excellent knowledge of medical terminology.
  • Excellent communication skills, including listening, written, and spoken.
  • Excellent investigative and analytical skills.
  • Strong problem-solving and critical thinking skills, with the ability to draw valid conclusions and effectively communicate them.
  • Detail-oriented with a high degree of accuracy regarding data entry.
  • Excellent time management and organizational skills, with the ability to prioritize in a fast-paced, changing environment.
  • Excellent negotiation, decision-making, and critical thinking skills.
  • Strong teamwork skills, with the ability to collaborate with others.

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