Specialist, Accident Benefits Claims
2 weeks ago
Definity is the parent company to some of Canada's most long-standing and innovative insurance brands, including Economical Insurance, Sonnet Insurance, Family Insurance Solutions, and Petline Insurance. Our ambition is to be one of Canada's leading and most innovative property and casualty insurers. We can't do that without our people, so we embrace and encourage a culture that's collaborative, ambitious, rewarding, and empowering.
We offer a flexible, hybrid work experience where employees work from the office and virtually depending on the type of work they are doing and who they are working with. Bring your true self and be a part of our journey. It's better here.
Reporting to the Team Leader, Accident Benefits, you are accountable for handling highly complex, severe and contentious Accident Benefit claims in accordance with the Statutory Accident Benefits Schedule.
What can you expect from this role?
- Handling files in good faith and in accordance with legislative requirements
- Handling LAT disputes with and without legal counsel
- Formulating file handling strategies and work plans
- Working with legal counsel
- Conducting settlement analysis
- Participating in Global Mediation and Private Arbitrations
- Providing coaching and support on file handling to Accident Benefit team members.
- Securing details of claims
- Assessing coverage eligibility
- Applying applicable Priority Rules chart to each claim file
- Reserving files appropriately after assessing claim
- Maintaining detailed file records on an electronic claims system
- Processing payments after confirming benefits, eligibility and reserves
- Coordinating the most effective course of action for claims
- Responding to claimant correspondence and Accident Benefit forms in accordance with the applicable legislation
- Reviewing and approving, when appropriate, treatment plans for claimant rehabilitation.
- Arranging insurer examinations to determine benefit eligibility
- Obtaining medical information necessary for insurer examinations
- Responding to assessment recommendations
- Handling complex AB claims including those involving catastrophic injuries
- Other duties as assigned
Personal Characteristics:
- Professional, friendly and courteous in all interactions, whether with customers or co-workers.
- Perform well in a busy operation and remain calm under pressure.
- Team player adaptable to a changing environment.
Strong written and verbal communication skills.
What you bring to this role?
- 5 years of experience handling Accident Benefits claims
- Excellent working knowledge of the Statutory Accident Benefits Schedule.
- Experience coaching others.
- University degree in any discipline or a college diploma in related field or the CIP designation
- Excellent verbal and written communication skills.
Salary range is $69,000- $127,000
Interested in this role, but don't meet every requirement? We encourage you to apply We know from experience that a candidate doesn't need 100% of the qualifications listed to bring incredible value to our team. We're actively seeking diverse backgrounds and perspectives to help us make insurance better. At Definity, inclusion, diversity, and equity aren't just "nice to have" — they're essential to our success.
What's in it for you?
- Hybrid work schedule for most roles
- Company share ownership program
- Pension and savings programs, with company-matched RRSP contributions
- Paid volunteer days and company matching on charitable donations
- Educational resources, tuition assistance, and paid time off to study for exams
- Focus on inclusion with employee groups, support for gender affirmation surgery, access to BIPOC counsellors, access to programs for working parents
- Wellness and recognition programs
- Discounts on products and services
Actual salary for the role may vary depending on work location of the successful candidate and other factors including but not limited to, skills, education, experience, working conditions and the local labour market. In addition to base pay, eligible employees may participate in various incentive plans which are paid out at the discretion of the company and subject to individual and company performance.
Go ahead and expect a lot — you deserve it.
It's better here — but don't take our word for it. Definity was named by Great Place to Work as one of the Best Workplaces in Canada for women, for youth, and for inclusion.
Our inclusive work environment welcomes diversity and supports accessibility. If you require accommodation at any time during the recruitment process, please let us know by contacting .
Background checks
This role requires successful clearance of background checks (including criminal checks and leadership references).
LI-HybridIND1
-
Mississauga, Ontario, Canada Desjardins Full time $80,000 - $120,000 per yearAs an Atlantic Accident Benefits Claim Advisor, you investigate, evaluate and negotiate accident benefits claims and help serve and maintain business relationships with members and clients. Proactively, you contact clients to establish rapport, discuss the claims process, and explain applicable benefits. You guide them through the claims process,...
-
Claims Specialist
1 week ago
Mississauga, Ontario, Canada Intact FC Full time $80,000 - $120,000 per yearOur employees are at the heart of everything we do. Together, we help people, businesses, and society prosper in good times and be resilient in bad times.Our employee promise represents Intact's commitment to you in exchange for living our Values, striving to do your best work, being open to change and investing in your career. In return, we promise to...
-
Section Manager, Accident Benefits
2 weeks ago
Mississauga, Ontario, Canada Desjardins Full time $90,000 - $120,000 per yearAs a Section manager, Accident Benefits you will oversee a team of claims advisors who focus on proactive, positive communications with clients to promote and facilitate their recovery from accident-related impairments. Your role involves using your ability to make quality decisions, optimize work processes, contribute to the organization's strategic plan,...
-
Claims Specialist LAT/CAT
20 hours ago
Mississauga, Ontario, Canada Desjardins Full time US$90,000 - US$140,000 per yearAs a Claims Specialist LAT/CAT, you support and coach a team of advisors responsible for handling complex catastrophic injury claims as well as claims involving disputes filed with the Licence Appeal Tribunal (LAT). You help review claims and issue claims settlement directives. You provide settlement opinions for complex claims and help internal advisors...
-
Mississauga, Ontario, Canada BlueSky Personnel Solutions Full time $90,000 - $120,000 per yearJob Title: Bilingual Benefits Program and Disability SpecialistLocation: Mississauga – OnsiteFull-time – PermanentThe Bilingual Benefits Program and Disability Specialist is responsible for the administration of group health, dental, vision, and disability benefits, as well as the management of workplace injury claims (WSIB/WCB). Acting as a trusted...
-
Mississauga, Ontario, Canada BlueSky Personnel Solutions Full time $60,000 - $90,000 per yearJob Title: Bilingual Benefits Program and Disability SpecialistLocation: Mississauga – OnsiteFull-time – PermanentThe Bilingual HR Benefits Program and Disability Specialist is responsible for the administration of group health, dental, vision, and disability benefits, as well as the management of workplace injury claims (WSIB/WCB). Acting as a trusted...
-
Claims Assistant
6 days ago
Mississauga, Ontario, Canada RBC Insurance Full time $42,000 - $60,000 per yearJob DescriptionWhat is the opportunity?The Medical Request Team (MRT) is responsible for requesting and following-up on medical documentation on behalf of the Claims Specialists. The MRT plays a key role in the claims process by allowing the Claim Specialist to focus on the adjudication process and not administrative tasks such as obtaining medical...
-
Claims Assistant
6 days ago
Mississauga, Ontario, Canada RBC Full time $45,000 - $65,000 per yearJob DescriptionWhat is the opportunity? The Medical Request Team (MRT) is responsible for requesting and following-up on medical documentation on behalf of the Claims Specialists. The MRT plays a key role in the claims process by allowing the Claim Specialist to focus on the adjudication process and not administrative tasks such as obtaining medical...
-
Mississauga, Ontario, Canada Desjardins Full time $104,000 - $130,000 per yearTemporary position fort 12 monthsAs a Senior Operational Performance Advisor, Accident benefits, you work with the Accident Benefits team, weighing in on a wide range of data sets that impact operational performance. You'll support the team with performance management by creating and updating various indicators and reports. You'll analyze and adapt...
-
Bilingual Claims Assistant
6 days ago
Mississauga, Ontario, Canada RBC Full time $60,000 - $80,000 per yearJob DescriptionWhat is the opportunity? The Medical Request Team (MRT) is responsible for requesting and following-up on medical documentation on behalf of the Claims Specialists. The MRT plays a key role in the claims process by allowing the Claim Specialist to focus on the adjudication process and not administrative tasks such as obtaining medical...