Examiner II

Aon Hewitt has announced BCAA as a 2019 Platinum Level Best Employer! 

What BCAA offers you:

  • It’s not in our nature to brag but we are proud of some of our achievements that recognize great employee culture. Some of our latest awards include being a 2019 Platinum level Best Employer by AON and being recognized as a 2018 Outstanding Workplace by YWCA.
  • Our team members get to make a difference in the lives of our Members and their communities every day.
  • We pride ourselves in being open and transparent and in empowering our people to do great work while serving our Members. 
  • We enthusiastically support learning and advancement opportunities for our team members.
  • We are an equal opportunity employer that’s committed to accessible, inclusive employment. 
  • Our Regular Full-Time & Part-Time+ (working 20 hours or more per week) status team members are eligible to participate in our amazing Total Rewards Program which offers: Extended Health and Dental, Vision Care, Life Insurance, RRSP matching with company contribution to your pension, access to Incentive Programs, Team Profit Sharing, Employee & Family Assistance Program and more.
  • Team members at our Home Office also get to use our Shared EV (electric vehicle) Program, have access to our subsidized cafeteria and free fitness centre.

BCAA's Claims Department is hiring a Regular Full-time Examiner II. The Examiner II reviews losses handled by independent adjusters and administers the claims process within the BCAA Insurance Corporation and sees that loss settlements are negotiated within the appropriate Provincial Statutes, and in line with corporation procedures and philosophies of BCAA’s underwritten lines of business.  The scope of the position and the nature of the cases handled is determined by the Claims Characteristics Table accompanying the job description.

Key Responsibilities:

Examines Claim Investigation and Adjustment Activities:

  • Directs Independent Adjusters to ensure that Corporation procedures and philosophy are being carried out.
  • Ensures where applicable, sections of the BC Insurance Act and Provincial Statutes relevant to claims are being adhered to, including Insured’s rights and obligations.
  • Reviews and examines loss files including verification of all documents for compliance with settlement agreement. 
  • Investigates the legitimacy of the claim. 
  • Orders interviews and/or 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 and quantify the loss. 
  • Reviews IA investigation of the claim and policy wordings in order to determine if the policy will respond to the loss.  
  • Reviews IA recommendations and approves or directs the handling of the file accordingly. 
  • Sets and maintains appropriate reserves within Limits of Authority.
  • Informs management if claim exceeds Limits of Authority, and makes recommendations where appropriate.
  • Ensures Service Delivery Partners are working within prescribed standards.
  • Maintains and organizes claims files in accordance with Claims department standards.
  • Ensures claims are processed accurately and on a timely basis and that negotiations are conducted on a professional basis.
  • Maintains professional working relationships with the Insured and Service Delivery Partners. 

Negotiate and Settle Claims:

  • Directs or approves the negotiation of a fair and cost effective settlement with the insured, claimant 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 proceed where appropriate. May take over subrogation from IA which may involve seeking legal counsel/action and attending settlement conferences
  • Arranges disposal of salvage arising from settled claims in accordance with Claims departmental standards.
  • Periodically steps in to complete claims settlement through direct adjusting. 

Claim Assignment:

  • Provides feedback for monitoring and managing the 24 Hour Emergency Claims Service.
  • Assists in the assignment of claims to Independent Adjusters where appropriate 

General Responsibilities:

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

Relationships:

  • External: BCAA Members and Insureds, Service Delivery Providers, Authorities, Lawyers, IBC Investigative Services, Other Stakeholders as required
  • Internal: Functional relationships with Underwriting, Insurance Marketing, Insurance Agency, Finance, and other departments as required 

Qualifications:

  • Education: Post-secondary diploma in business or related courses, programs, licenses (insurance related) and/or equivalent work experience.
  • Experience: 5 to 9 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-tasking and organizational skills

Preferred:

  • CIP designation
  • Second Language