Claims Specialist

• Responsible for a portfolio of examining and direct handle property claims, percentage share based on demand
• Resource field work to be completed by IA by setting clear expectations and timelines and managing the file through to completion
• Arrange market calls or work with various insurers on subscription claims
• Prepare and be able to present a complete file strategy, coverage analysis, disposition and business case
• Investigate claims by reviewing the IA reports and specialists in order to acquire facts and information to analyzing the loss
• Review and compile facts, policies, technical reports, analyze estimates, value of claim, and settle claims
• Communicate claim adjustments via written reports to all parties
• Provide outstanding service to our customers
• Responsible for data accuracy and issuing payments to vendors, insureds, and specialists
• Ensure all correspondence is completed in a timely and effective manner including the creation of Critical Path Letters, Proof of Losses, and Reservation of Rights letters etc
• Responsible for recognizing questionable claims, subrogation, and risk opportunities

Property Claims Examiner

• Responsible for assessing claims for benefit by reviewing contractual, medical, and functional information and in accordance with certificate provisions, adhering to established routines and processes for our various clients;
• Follow up with diligent communications with the different stakeholders, to obtain or provide information regarding claim status and reasoning, and complete reporting as required;
• Thoroughly document the analysis according to Securian’s policies and processes;
• Effectively manage an active caseload in accordance with client service standards and best practice guidelines and established KPI’s and TAT’s;
• Contribute to and foster a positive and dynamic working environment by supporting team members and through collaboration to department project work, and with plan members, plan sponsors and other stakeholders, to ensure service standards are met;
• Learn and apply tools and technology that support continuous improvement by identifying opportunities to improve processes and customer service delivery and adapting to changes as improvements are implemented;
• Perform other related duties, as assigned.

Claims Examiner, 18 months contract

Claims Examiner – 18 months contract

• Analyzing and adjudicating mechanical warranty claims for various types of vehicles.
• Processing claims, determining eligibility, and authorizing repairs in accordance with active contracts.
• Assigning inspectors when required and identifying abusive or potentially fraudulent claims.
• Communicating decisions to claimants and answering questions regarding coverage or the claims process.
• Calculating and issuing required payments.
• Following up on files and collaborating closely with internal teams.
• Managing level 1 complaints and escalating those requiring higher-level follow-up.
• Performing any other duties assigned by management.

Mechanical Warranty Claims Adjuster

• Produce reports with occasional guidance from Manager
• Direct Field Adjusters on task assignment investigations
• Settle claims directly with Insureds or their representatives
• Administer claims payments/settlements through trust accounts
• Liaise with all stakeholders to ensure client's needs are met
• Report back to the syndicate or self-insured according to their guidelines

Property Claims Examiner Trainee

• Provide a superior quality of customer service to external and internal customers, through proactive contact with the customer during the claims process.
• Assess and analyze policy wordings and damage to determine appropriate coverage.
• Investigate property claims in a timely manner through communication with the customer, vendors, experts, adjusters and any other related parties.
• Negotiate with customers, third parties and insurers to settle claims, within your established authority scope.
• Provide phone queue support to complete new claims intake and handle inquiry calls.
• Stay in the know about current insurance products and trends in appraisal and investigation techniques and services.

Claims Adjuster I, Property

• Investigating and settling insurance claims to ensure a prompt and fair settlement
• Provide quality service and ensure prompt and equitable settlement of claims in line with corporate policies and standards
• Analyze and interpret insurance policy wording to determine coverage and assess entitlements which are fair and equitable
• Communicate in a timely and respectful manner with the customer, claimants, lawyers and insurers to settle claims and report findings and settlements
• Conduct investigations and identify additional information such as independent medical examinations, customers medical or employment history required to clarify and/or justify a claim
• Collect reports and statements to determine liability and coverage
• Ensure all cases are clearly documented and meet any or all legislative requirements

Claims Adjuster I – Casualty

• Conduct on-site inspections and investigate relatively complex commercial and personal lines property claims in a timely and respectful manner through communication with customers, contractors, consultants and any other related parties
• Handle Field tasks on behalf of telephone adjusters
• Provide a superior quality of customer service to external and internal customers
• Analyze the information gathered, interpret insurance policy wording, determines coverage, assesses damage
• Negotiate with customers, claimants, lawyers, and insurers to settle claims, while managing costs efficiently and effectively

Senior Field Claims Adjuster, Property

• Review all new referrals from employers with Disability coverage adjudicated by DMI or stand-alone WOP benefits
• Set up clients with Early Intervention services and MTD/LTD coverage as Pre-claim files and refer to the EIP team for app facilitation
• Forward completed claims to the Intake Coordinator for claim set-up and assignment to a Case Manager
• Assemble and submit claims to external carriers following standard procedures
• Respond to all inquiries, emails, and voicemails within 1 business day of receipt

Claims Coordinator, 12-Month Contract

• Proactively evaluate individual disability claims using medical evidence and occupational insights
• Deliver clear, empathetic, and timely communication to clients
• Use critical thinking to make timely decisions based on claim assessments
• Articulate claim decisions clearly in writing and verbally
• Efficiently manage a high-volume of cases and calculate benefit payments
• Develop strong relationships with clients and key partners
• Collaborate seamlessly with cross-functional teams

Disability Claims Analyst, Individual Claims

• Proactively evaluate individual disability claims using medical evidence and occupational insights
• Deliver clear, empathetic, and timely communication to clients
• Use critical thinking to make timely decisions based on claim assessments
• Articulate claim decisions clearly in writing and verbally
• Efficiently manage a high-volume of cases and calculate benefit payments
• Develop strong relationships with clients and key partners
• Collaborate seamlessly with cross-functional teams to drive consistency and results

Disability Claims Specialist, Individual Claims

• Fairly and objectively assess disability claims using a multidisciplinary approach
• Deliver clear, empathetic, and timely communication to clients, employers, and partners
• Use critical thinking to make informed, timely decisions based on thorough evaluations of claim details
• Clearly articulate claim decisions in writing and verbally to address concerns
• Efficiently and accurately manage a high-volume caseload, calculate benefit payments
• Cultivate strong relationships with key stakeholders and claimants
• Collaborate seamlessly with medical, legal, and client service professionals
• Maintain focus and mental acuity to effectively handle complex cases

Disability Claims Specialist, Group Insurance

• Fairly and objectively assess disability claims using a multidisciplinary approach, prioritizing critical tasks while ensuring compliance with policies, procedures, and regulatory requirements.
• Deliver clear, empathetic, and timely communication to clients, employers, and partners, particularly when handling sensitive decisions such as claim denials.
• Use critical thinking to make informed, timely decisions based on thorough evaluations of claim details.
• Clearly articulate claim decisions in writing and verbally to address concerns, foster mutual respect, and manage escalations effectively.
• Efficiently and accurately manage a high-volume caseload, calculate benefit payments, and implement return-to-work strategies to support claimants’ recovery.
• Cultivate strong relationships with key stakeholders and claimants to facilitate recovery and successful return-to-work outcomes.
• Collaborate seamlessly with medical, legal, and client service professionals to ensure consistency and drive positive results throughout the claims process.
• Maintain focus and mental acuity to effectively handle complex cases and high-volume workloads.

Disability Claims Analyst, Group Insurance

• Review facts, policy, technical reports, fire marshal's reports, case law, and make decisions on coverage, value of first-party claims, and negotiate/settle the claims accordingly.
• Investigate by meeting with insureds, third parties, witnesses, and lawyers to acquire facts and information.
• Provide outstanding customer service and keep related parties advised of the claims status.
• Ensure data accuracy, issue payments to insureds, vendors, and other relevant parties.
• Negotiate and reconcile contractor estimates to arrive at an appropriate scope of repair and settlement.
• Conduct physical inspections of damaged properties, including taking photographs, using a drone, crafting diagrams, and completing a scope of damage and estimate using Xactimate estimating software.
• Identify large losses, questionable claim indicators, and subrogation opportunities early.
• Maintain accurate reserving of claims files.

Catastrophe Claims Adjuster

• Examine moderate to intermediate complex property claims
• Produce reports with occasional guidance from Manager
• Direct Field Adjusters on task assignment investigations
• Settle claims directly with Insureds or their representatives
• Administer claims payments/settlements through trust accounts
• Liaise with all stakeholders to ensure client's needs are met
• Report back to the syndicate or self-insured according to their guidelines

Property Claims Examiner Trainee – Full Time

• Work with Manulife’s Third Party Providers of emergency medical assistance.
• Make final claims decisions and business decisions on contested claims.
• Handle travel litigated claims and correspond with legal counsel.
• Investigate, resolve, and respond to escalated complaints.
• Conduct monthly audits of travel claims processed by Third Party Providers.
• Provide input on contract wording for new and existing products.

Senior Travel Claims Specialist

• Maintains a well-organized and efficient book of CGL bodily injury and Auto bodily injury claims across Canada (excluding Quebec).
• Handle claims start-to-finish including investigation, coverage review, reserve management, negotiating, and settlement in a cost-effective manner.
• Engage in thorough investigation of moderate to high complexity claims through communication with insureds, claimants, and plaintiff counsel.
• Works with Independent Adjusters/surveyors and defense counsel in accordance with established guidelines.
• Reviews and assess liability exposure based on legal principles and case analysis reports.
• Attends settlement meetings, mediations and pre-trials.
• Ensure timely issuance of settlement funds and disbursements.
• Completes proper internal reports in a timely manner and sent to the appropriate Head Office department.
• Contributes to profitability through managing expenses as per file handling best practices.
• Work closely with all levels of CNA’s internal and external broker business partners to share knowledge and developments on claims.
• Makes recommendations on claims policy and processes to further enhance the claim department.
• Able to react to change productively and handle other essential tasks and projects as assigned.

See all jobs on JobTailor

Property Claims Examiner

Claims Examiner, 18 months contract

Claims Examiner – 18 months contract

Mechanical Warranty Claims Adjuster

Property Claims Examiner Trainee

Claims Adjuster I, Property

Claims Adjuster I – Casualty

Claims Adjuster I, Property

Senior Field Claims Adjuster, Property

Claims Coordinator, 12-Month Contract

Disability Claims Analyst, Individual Claims

Disability Claims Specialist, Individual Claims

Disability Claims Specialist, Group Insurance

Disability Claims Analyst, Group Insurance

Catastrophe Claims Adjuster

Property Claims Examiner Trainee – Full Time

Senior Travel Claims Specialist

Senior Claims Adjuster