Adjuster (Accident Benefit)

3 days ago

Toronto, Canada SGI Full time
Do you value integrity and innovation? How about passion and caring? Great Us too, and that's why you'll fit right in. Our intentional culture promotes trust and participation, encouraging you to bring your heart and mind to work every day.

Out-of-Scope

Permanent, Full time

Location: This position can be in any one of our Toronto Offices (Toronto West or Toronto East Office). Hybrid work option available, this means you’ll have the flexibility of working from home and in the office (indicated above), on a scheduled rotation after the training period has been completed.

The successful candidate will be responsible for investigating, negotiating and settling routine automobile accident benefit claims that are within the Minor Injury Guideline (MIG). Determines coverage in accordance with policy wordings and applicable automobile accident benefits legislation and regulations.

Key Accountabilities

Note: This section is not intended to be an exhaustive list of duties and responsibilities – other duties and responsibilities may be assigned.

Claims Adjusting

  • Adjudicates routine accident benefits claims within the MIG.

  • Assigns, conducts and oversees investigations and examines, negotiates and settles accident benefits claims.

  • Maintains a diary system to monitor and ensure delivery of accident benefits payments in accordance with the regulations.

  • Ensures file records are up to date with all information, notes and documentation.

  • Maintains proper reserves as per exposure and developments.

  • Responsible for the issuance of payment requests for outsourced files.

Customer Experience

  • Supports corporate culture and vision which fosters positive relationship with our customers.

  • Provides timely and professional customer service.

  • Handles claims issues and resolutions in a proactive manner.

Stakeholder Relationship

  • Builds and maintains positive working relationship with insureds, brokers, service providers and industry participants.

Leadership

  • Actively contributes to and supports a culture of a high performing workforce. Participates in divisional succession plans, ensuring ongoing professional and career development and supports development in others. Supports a culture of leadership and accountability to effectively deliver on strategic and corporate strategies.

  • Is actively committed to leadership development across the company, supporting team and workforce readiness through mentoring, training and developmental opportunities.

Corporate Management

  • Enables the success of programs and policies that are in alignment with corporate, strategic and divisional strategies. 

  • Manages risk in area of authority.

  • Ensures that the Health, Safety and Emergency Management Policy is applied in area of responsibility.                                

                                      

Education & Experience

  • A two-year diploma from an accredited post-secondary education institution in a relevant field of study such as Business or Health.

  • 1 – 3 years’ experience in claims or insurance related role.

Knowledge, Skills and Abilities

  • Knowledge of Ontario’s automobile accident benefits legislation and regulations, including the statutory accident benefits schedule.

  • Knowledge of the principles and practice of insurance, claims policies and procedures, and automobile insurance products.

  • Knowledge of medical terminology and vocational rehabilitation concepts.

  • Knowledge of the legal process as it relates to accident benefits.

Behavioural Competencies

Leader Level 2 – Applies (Self & Others)

  • Accountability - Goes Beyond Basic Expectations to Implement Customer/Partner Focused Solutions

  • Business Acumen - Applies Business Fundamentals and Thinks in Future-Oriented Terms

  • Change Agility - Is Nimble; Shifts Gears Quickly and Comfortably

  • Leadership - Leads Self and Others

Posting Close Date:

July 8, 2024

As you prepare to submit your application, and cover letter if applicable, please highlight the achievements that demonstrate why you're a great candidate for this role.

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