Claims Specialist

• Investigates, manages, and settles high complexity property claims and various claims.
• Provide a superior quality of customer service to external and internal customers.
• Analyze the information gathered, interpret insurance policy wording, determines coverage, assesses damage.
• Within established authority limits, negotiate with customers, claimants, lawyers, and insurers to settle claims, while managing costs efficiently and effectively
• Gather factual versions of the circumstances of the claim from insureds, third parties and other stakeholders to determine the circumstances, causes and eligibility of claims.
• Assist in the evaluation and negotiation of large losses
• Anticipate recoveries and direct the investigation accordingly.
• Actively collaborate with the various related departments in the claims and underwriting departments, as well as outside specialists.
• Build relationships and collaborate with different teams including our rely partners, engineers, appraisers, underwriting and legal.
• Adhere to company standards and guidelines for file documentation while ensuring sound management of external fees and costs.
• Stay in the know about current insurance products and trends in appraisal and investigation techniques and services.

Claims Specialist, Property

• Investigates, manages, and settles high complexity property claims and various claims.
• 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.
• Gather factual versions of the circumstances of the claim from insureds, third parties and other stakeholders to determine the circumstances, causes and eligibility of claims.
• Assist in the evaluation and negotiation of large losses
• Actively collaborate with the various related departments in the claims and underwriting departments, as well as outside specialists.
• Build relationships and collaborate with different teams including our rely partners, engineers, appraisers, underwriting and legal.
• Adhere to company standards and guidelines for file documentation while ensuring sound management of external fees and costs.
• Stay in the know about current insurance products and trends in appraisal and investigation techniques and services.

• Investigate, evaluate, negotiate, and settle BI claims in accordance with Aviva's procedures and philosophy
• Interpret and confirm insurance coverage using background knowledge of relevant case law combined with a thorough understanding of policy wordings
• Investigate, evaluate and settle a diverse claims pending of litigated and non-litigated files
• Develop appropriate strategy to direct handle files to conclusion and/or teach Independent Adjuster's as needed
• Ensure file reserves are set on a timely and accurate basis, in line with company protocols
• Maintain control over expenses through pro-active handling techniques
• On litigated files, work in partnership with defence counsel to develop and implement strategies for bringing files to a timely and cost effective resolution
• Provide excellent customer and partner communication on claim matters
• Clearly document and summarize file activity
• Understand and adhere to Aviva’s claim procedures and guidelines
• Provide superior customer service to our clients and partners

Casualty Specialist – Bodily Injury Claims

• Conducting in-depth analyses of disability claims
• Determining eligibility for benefits
• Managing complex or high-impact claims
• Preparing clear and professional written communications
• Maintaining regular communication with policyholders
• Contributing to continuous improvement initiatives

Individual Disability Claims Analyst

• Investigate high-value and complex personal lines property claims in a timely and respectful manner through communication with customers, contractor, consultants, brokers, and any other related parties
• Perform field inspections and related tasks to support multiline adjusters, while also directly managing field property claims
• Provide a superior quality of customer service to external and internal customers, and answer queries relating to the claims process
• Document the claims file by meeting with all involved parties and obtaining appropriate reports and statements from customers, appraisers, third party adjusters, claimants, witnesses, police, and any other pertinent experts to determine coverage
• Analyze the information gathered, interprets insurance policy wordings, determines coverage, assesses damage
• Within established authority limits, negotiate with customers, claimants, lawyers, and insurers to settle claims
• Keep up to date on Intact’s Prestige products, appraisal and investigation techniques, and services

• Help customers over the phone with their casualty claims, mainly in the area of property damage and primarily in Personal Lines insurance (claims of $100,000 or less)
• Guide customers through the various stages of their claim: analyze the admissibility of the claim, conduct an investigation, evaluate damages claimed, and negotiate settlements if appropriate
• Listen to the customer and clearly explain the claim handling process, answer questions and deliver service that goes beyond the customer’s expectations
• Evaluate the potential liability of the insured and/or third parties based on findings
• Communicate effectively with customers to inform them of developments and annotate files according to company guidelines
• Manage expenses and external costs and assist in responding to catastrophes when they occur

Claims Adjuster II, Casualty

• To analyze mid- and higher-level general auto claims to determine scope of damages.
• To ensure ongoing adjudication of claims within company standards and industry best practices.
• To identify subrogation of claims and negotiate settlements.
• Manages mid-level and higher-level auto commercial and personal lines claims by gathering information to determine exposure.
• Assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
• Assesses liability and resolves claims within evaluation.
• Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
• Manages subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures claim files are properly documented and claims coding is correct.
• Maintains professional client relationships.

Claims Adjuster – Auto, Temporary

• Coach internal advisors to develop their technical skills
• Provide contract enforcement advice, verify settlement costs and ensure compliance with claims policies
• Revise independent adjuster claims
• Review claims and help advisors and practitioners settle them
• Conduct research and serve as resource person, proposing solutions to conflicts and situations outside the expert’s scope of authority
• Help prepare action plans based on claims reviews
• Verify and approve claims settlements

Claims Analyst

• Support our claims customer demand through a call-center environment
• Investigate and negotiate property claims in accordance with Aviva's claim procedures and guidelines
• Responsible for confirming coverage and compiling FNOL information for incoming claims
• Responsible for data accuracy and the issuance of payments to vendors, insureds and experts
• Review and compile facts, policy, and technical reports, analyze estimates, value of claim and negotiate/settle claim accordingly
• Effectively advise and counsel customers on claim status, provide prompt and exemplary customer service and while keeping related parties informed of the claims status
• Responsible to ensure all correspondence is completed in a time efficient/effective manner including the creation of Critical Path, Proof of Loss and reservation of rights letters etc...
• Responsible for recognizing questionable claims, subrogation and risk opportunities
• Also responsible for reviewing case law to determine liability.
• Meets Property team performance expectations that are set individually and contributes to team success
• Adheres to and supports policies surrounding attendance

National Property Claims Adjuster

• Support Optiom’s transition of warranty claims handling from a third-party model to an in-house capability
• Work closely with the Claims Supervisor and Optiom’s contracted warranty technical advisor
• Manage warranty claim intake and documentation
• Verify coverage eligibility and policy terms at intake
• Create and maintain complete, accurate claim files in the claims management system
• Review repair estimates, diagnostic reports, and work orders
• Coordinate with the contracted warranty technical advisor
• Apply coverage terms to repair findings
• Escalate complex or disputed claims to the Claims Supervisor
• Communicate claim status, coverage outcomes, and next steps to policyholders and dealer partners
• Contribute to building out Optiom’s internal warranty claims knowledge base

Warranty Claims Specialist

• adjust claims while ensuring that business development opportunities are maximized.
• marketing and follow-up of opportunities in a timely manner.
• create a dynamic portfolio requiring extremely well-honed organizational skills to enable day to day activities to be completed while allowing efficient and effective progress of file management activities.

Liability & Casualty Claims Adjuster

• Open new claims over the phone with customers, then ensure the situation is handled immediately
• Interview insureds and/or witnesses to gather their accounts of events
• Determine whether the claim is covered or not by analyzing the insured’s policy details
• Analyze the information obtained, make decisions to determine liability and review damage assessments
• Settle claims fairly and equitably, confirm damage amounts and make payments

Auto Claims Adjuster – Insurance Graduate

• Open new claims over the phone with customers, then ensure the situation is handled immediately.
• Interview insureds and/or witnesses to gather their accounts of events.
• Determine whether the claim is covered or not by analyzing the insured’s policy details.
• Analyze the information obtained, make decisions to determine liability and review damage assessments.
• Settle claims fairly and equitably, confirm damage amounts and make payments.

Auto Claims Adjuster

Auto Claims Adjuster – AMF Licence

• 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 Specialist jobs in Canada

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Claims Specialist, Property

Claims Specialist, Property

Casualty Specialist – Bodily Injury Claims

Individual Disability Claims Analyst

Claims Specialist, Property

Claims Adjuster II, Casualty

Claims Adjuster – Auto, Temporary

Claims Analyst

National Property Claims Adjuster

Warranty Claims Specialist

Liability & Casualty Claims Adjuster

Auto Claims Adjuster – Insurance Graduate

Auto Claims Adjuster

Auto Claims Adjuster – AMF Licence

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