Claims Examiner

Serving a diverse urban and rural population of more than 430,000, Niagara Region is focused on building a strong and prosperous Niagara. Working collaboratively with 12 local area municipalities and numerous community partners, the Region delivers a range of high quality programs and services to support and advance the well-being of individuals, families and communities within its boundaries. Nestled between the great lakes of Erie and Ontario, the Niagara peninsula features some of Canada’s most fertile agricultural land, the majesty of Niagara Falls and communities that are rich in both history and recreational and cultural opportunities. Niagara boasts dynamic modern cities, Canada’s most developed wine industry, a temperate climate, extraordinary theatre, and some of Ontario’s most breathtaking countryside. An international destination with easy access to its binational U.S. neighbour New York State, Niagara attracts over 14 million visitors annually, as well as a steady stream of new residents and businesses.

Please note that the Niagara Region requires that all newly hired employees are to be fully vaccinated against COVID-19 as a condition of being hired and provide proof of full vaccination, or provide proof of a bona fide medical or Human Rights Code exemption on a form issued from and approved by Niagara Region.

Approximate Duration: up to 12 months

Job Summary

Reporting to the Risk Management Program Manager, the Claims Examiner is responsible for the administration of claims, including claim response, assessment, defense, settlement negotiation, and the disposing of claims as delegated by the Risk Management Program Manager for the Corporation, the Niagara Police Services Board/Niagara Regional Police Service (NRP) and Niagara Regional Housing (NRH).

Education

  •   Post-secondary degree or diploma in a related field.

  •  An equivalent combination of education, experience and qualifications may be considered.

    Knowledge

  •   3 years to 5 years in the insurance industry with focus on liability claims.

  •  Successful completion of a CIP (Chartered Insurance Professional) or CRM (Canadian Risk

    Management) designation.

  •  Working knowledge of Microsoft Office Suite, internal investigative processes and legislation that

    governs all operations of the Niagara Region, NRP and NRH.

  •  Formal training in communication skills, negotiation skills and time management.

Responsibilities

Investigates, negotiates, resolves or denies claims made against and on behalf of the Niagara Region, NRP and NRH for bodily injury, property losses and general liability within authorized limits as delegated by the Risk Management Program Manager and/or Director of Legal and Court Services. (45% of time)

  •  Obtains and secures documentation and statements from claimants, witnesses, police authorities, emergency personnel and senior staff to assist in determining liability and negotiating the compensation or resolution of losses.

  •  Communicates with claimants, witnesses, police authorities, emergency personnel, experts, insurers, councilors, senior staff, adjusters and outside legal counsel in the resolution of claims.

  •  Advises and supports individual Regional employees regarding court proceedings, claims investigation, insurance requirements, insurance renewal processes and defense processes.

  •  Retains the services of and directs outside experts, such as appraisers, engineers, medical specialists, rehabilitation firms and outside counsel as required and as authorized.

  •   Investigates, negotiates, and settles first party self-insured claims made on behalf of the Niagara Region, NRP and NRH for property damage and losses within authorized limits as delegated by the Risk Management Program Manager and/or Director of Legal and Court Services.

Interprets insurance policy provisions to determine coverage under the policies of insurance and supports the annual insurance renewal process (20% of time)

  •  Reviews loss data and risk management services, identifying loss exposures and recommending loss prevention and control techniques to Risk Management Program Manager and/or Director Legal and Court Services.

Builds and maintains effective partnerships with all internal and external stakeholders (15% of time).

  •  Advises and supports Niagara Region staff as well as members of Niagara Regional Police Services Board/Niagara Regional Police and Niagara Regional Housing, with various issues such as preparing for court proceedings, gathering evidence for claim investigations and insurance renewal processes.

  •  Liaises with claimants, witnesses and third parties through the claims resolution process.

  •   Develops and manages relationships with external auditors, internal and third-party legal counsel, insurance providers, and other vendors to ensure business needs are addressed.

  •   Develops and maintains effective working relationships and communications with area municipalities, the province and shared service partners to gather information, track trending data, and resolve issues and complaints.

Prepares reports and records as directed, including drafting and serving court documents as delegated by Risk Management Program Manager. (15% of time)

  •   Completes all required forms in accordance with Legislated Regulations or internal procedures.

  •   Prepares reports for Council and external auditors on claim settlements, reserves and status of

    Claims within authority delegated by Risk Management Program Manager.

  •   Records claims expense data and creates financial reports and spreadsheets for budgeting and

    forecasting purposes.

Attends and represents the Niagara Region, NRP and NRH at mediations, settlement conferences and similar legal proceedings within delegated authority. (5% of time)

  •   Completes all necessary documentation to support attendance.

  •   Liaises with client department for instructions and obtains proper authority for settlement negotiations.

  •   Engages with external legal counsel and insurer, reviews Briefs filed in support of hearing and prepares necessary reports.

Perform other related duties and responsibilities as assigned or required.

Special Requirements

  •  Regional staff strive to enable the strategic priorities of council and the organization through the completion of their work. Staff carry out their work by demonstrating the corporate values of service, honesty, choice, partnership and respect.

To view the full job description and requirements, visit our Careers page - Job Opening #33610
Uncover the wonder of the Niagara Region and join a team dedicated to meeting tomorrow’s challenges.....today!

Let us know why you would be an excellent team member by submitting your online application no later than October 10, 2022 before midnight by visiting our ‘Careers’ page at www.niagararegion.ca . We thank all candidates for their interest however, only those candidates selected for an interview will be contacted.