Claims Adjuster II

The Claims Adjuster 2 operates within Claims Performance Standards to Property and Casualty Insurance Claims (homeowners, recreational vehicle, classic car, travel accident benefits) primarily by telephone and determines if coverage is available for a loss within the insuring agreement, and then proceeds to settle or deny the claim.

Key Responsibilities:

Investigate and Adjust Claims

• Advises insured of the rights and obligations in accordance with the policy and the appropriate Insurance Act. 
• Maintains a professional working relationship with the insured.
• Investigates the claim in order to determine if the policy will respond to the loss and investigates the legitimacy of the claim.
• Interviews and/or takes statements from policyholders, claimants and witnesses.
• Reviews information including, but not limited to, estimates, photos and/or videos of property damage, proof of ownership, hospital records, and other pertinent information required to fully substantiate the claim.
• Receives and evaluates information to determine cost of loss.
• Informs manager if claim exceeds authority limits, making recommendations where appropriate.
• Sets and maintains appropriate reserves to maximum authority level.
• Ensures Service Delivery Partners are working within prescribed standards.
• Maintains updated, current and organized claims files in accordance with Claims Performance Standards.

Negotiate and Settle Claims:

• Negotiates a fair and cost effective settlement with the insureds', claimants or claimant’s legal representative either directly or through the services of retained counsel.
• Validates information, including but not limited to invoices and receipts.
• Processes payments in accordance with BCAA best practices.
• Assesses economic feasibility to pursue subrogation and proceeds where appropriate.
• Arranges disposal of salvage arising from settled claims in accordance with departmental standards.
• Periodically performs some responsibilities of Examiner 1.

General Responsibilities:

• Remains current on industry knowledge and incorporates information as appropriate.
• Participates in claims dispute resolution process as required.
• Periodically receives call and opens claim file.
• Carries out other related tasks and projects as assigned

Qualifications:

• Education: Post-secondary diploma in business or related courses, programs, licenses (insurance related) and/or equivalent work experience. CIP 30% complete and committed to CIP graduation
• Experience: Minimum 3 years in a claims environment
• Technical: MS Office
• Excellent analytical skills
• Ability to handle irate people and stressful situations
• Demonstrated ability to adapt and be flexible to changing business needs
• Excellent listening skills
• Troubleshooting methodologies
• Excellent oral and written communication skills
• Demonstrated ability to meet deadlines
• Ability to work both independently and with other team members
• Demonstrated ability to be proactive when dealing with issues and challenges
• Excellent analytical and troubleshooting skills
• Excellent multi-taking and organizational skills
• Preferred:
  • Manager experience in a claims environment
  • Second language