Senior Adjuster, Accident Benefits Claims

At Heartland Mutual Insurance, we're more than just a company — we're a community.

Proudly rooted in Ontario and Nova Scotia, we're driven by a bold vision: to be the Best Mutual. Our team of passionate professionals doesn't just follow the norm — we challenge it. We think differently, aim high, and deliver on our promise with a personal touch.

Here, you'll be part of a culture that values authenticity, embraces change, and empowers you to make a meaningful impact every day. Together, we bring our purpose to life by living our values and putting people first.

Senior Adjuster, Accident Benefits Claims - Waterloo, Ontario

The Senior Adjuster, Accident Benefits Claims, is responsible for managing the most complex AB claims in accordance with the Statutory Accident Benefits Schedule (SABS), including catastrophic injuries, lifetime and optional benefits, annuity settlements, and files involving LAT hearings or arbitration. This role provides leadership within the team, ensuring file quality, technical excellence, and consistent application of regulatory requirements. The Senior Adjuster supports strategy execution, provides training and mentorship, and collaborates across departments to advance Heartland Mutual Insurance's claims service objectives.

What you'll do...

Complex Claims Management:

• Manage complex and high-severity AB claims, including those involving catastrophic injuries, annuities, and lifetime/optional benefits.
• Represent the company in LAT hearings, arbitrations, and mediations, preparing documentation and collaborating with legal counsel.
• Conduct technical file reviews, maintain reserve accuracy, and manage complex benefit entitlement evaluations.

Escalation, Dispute Resolution & Legal Coordination:

• Lead internal strategy on files involving high-value disputes or precedent-setting risk.
• Collaborate with legal counsel, external experts, and medical providers to ensure files are defensible and well-documented.
• Oversee insurer examinations and treatment plan approvals for high-exposure files.

Mentorship, Leadership & Training:

• Mentor and support Level II and III AB Adjusters by sharing expertise and assisting in file triage.
• Participate in onboarding, technical coaching, and calibration of claims handling practices.
• Collaborate with the Training Lead and QA Specialist to support training content and quality control processes.

Stakeholder Communication and Customer Advocacy:

• Communicate with empathy and professionalism with claimants, legal representatives, brokers, Agents, and Direct Sales Center staff.
• Provide resolution-focused communication strategies to support positive outcomes and reduce customer friction.

Regulatory Compliance and Technical Contribution:

• Ensure compliance with all SABS regulations and reporting standards.
• Stay current on industry trends, case law, and changes in legislation affecting AB claims.
• Lead Priority and Loss Transfer reviews across assigned files and support audits as required.

Continuous Improvement and Departmental Collaboration:

• Identify process inefficiencies or improvement opportunities and contribute to workflow optimization.
• Participate in CAT response and readiness initiatives as needed.

What you'll bring...

Education & Experience:

• Minimum 6+ years of Accident Benefits adjusting experience.
• Post-secondary education in Insurance, Law, or Business; CIP designation required.

Technical Skills & Knowledge:

• Expert knowledge of the SABS, LAT/arbitration processes, and catastrophic injury claim handling.
• Advanced analytical and negotiation skills.
• Proficiency in claims systems, regulatory reporting tools, and digital workflows.

Competencies:

• Exceptional communication, leadership, and decision-making skills.
• High attention to detail and ability to manage sensitive, high-profile files.
• Professionalism, emotional intelligence, and a collaborative mindset.

If you have the qualifications we are seeking and would thrive in a work environment where you are valued and respected, please apply on the company website. Accommodation is available on request for candidates taking part in all aspects of the selection process.

What's in it for You:

• Join a Supportive Team: Be part of a collaborative and high-performing team that values knowledge sharing and celebrating wins together.
• Comprehensive Total Rewards: Enjoy a competitive compensation package, including health and wellness benefits, pension plan, paid time off, and more.
• Career Growth & Development: Take advantage of continuous learning opportunities and stretch assignments.
• Make an Impact: Play a key role in helping customers navigate challenging situations with empathy and expertise.
• Inclusive Culture: Work in an environment that embraces diversity, equity, inclusion and belonging.

At Heartland Mutual Insurance, you're empowered to thrive. Whether it's your career, your well-being, or your future, we've got you covered.