Claims Reviewer

Employer
Facility Association
Location
Toronto, ON
Starts
Closes
Job Category
Insurance

Reporting to:                    Director of Claims

Location:                           Remote/2235 Sheppard Avenue E/777 Bay Street  

Status:                               Full Time, Permanent

Posting Date:                    October 27, 2022

Closing Date:                    December 8, 2022

 

Claims Reviewer

 

ABOUT FACILITY ASSOCIATION:

The Facility Association (“FA”) is an unincorporated non-profit organization established by the automobile insurance industry to ensure that automobile insurance is available to all owners and licensed drivers of motor vehicles where such owners or drivers are unable to obtain automobile insurance through the voluntary insurance market.

Additional information in relation to Facility Association is available on its website:

http://www.facilityassociation.com

We are looking for exceptional talent to join our team as we expand the Underwriting, Claims and Operations department and continue to build on our unique position to serve the industry and the Canadian public.  FA is continually transforming to serve our stakeholders better and we invite all persons who are passionate about insurance to apply for the position as a Claims Reviewer.

 

OBJECTIVE:

The primary objective of the Claims Team at Facility Association is to oversee many functions including Large Loss Claims, Run-off Claims, the Uninsured Automobile Fund and Judgement Recoveries. This is not an adjusting role, although it is essential to have loss adjusting experience. This position reports to the Director of Claims, Underwriting, Claims & Operations Department.  Building and influencing relationships with FA staff, external project managers, Claims Committee members, retained counsel, and other stakeholders.

As a Claims Reviewer, you will be responsible for reviewing and monitoring all Large Loss claims reported from our Members and Servicing Carriers.  You will provide recommendations on claims and/or request additional information if required.  You will present information to the Claims Committee on any losses where you require a second opinion. This will include preparing analytical reports, recommendations and briefing notes to seek advice from the Claims Committee regarding any complex claims. 

You will work with an independent adjuster to monitor run-off claims.  You will monitor the progress and resolution of the claims through the review of regular reports, providing technical guidance and instruction.  You will ensure reserves are set, payments are processed and the claim is handled in compliance with regulations and legislation.   

The Facility Association is required under the respective provincial insurance Acts to administer the Uninsured Automobile Funds in the Atlantic Provinces.  We monitor the investigation, defense and final settlement of these claims through the assistance of designated law firms.  As a Claims Reviewer, you will provide technical direction and instructions to legal counsel, review settlement recommendations from counsel and prepare reports for leadership review and approval.  You will also oversee judgment recovery files to ensure that the designated law firms are pro-active in their collections from debtors.  You will ensure reserves are set and payments are processed.

You will have input on any changes required to our Claims Guides and/or Mandates, and will prepare documentation for Claim Committee, Senior Leadership, and regulator approval.  You will complete the research, development and implementation of new/revised claims procedures and standards.

DUTIES AND RESPONSIBILITIES:

  • Review large loss claims and provide feedback to Servicing Carriers and Members.
  • Liaise with an independent adjuster on open Run Off claims.
  • Work with retained counsel on the Judgement Recovery files and UAF claims with the goal to bring these to closure in a fair and equitable manner.
  • Review vendor invoice and indemnity submissions on Run Off, FARM Legal Reimbursement, UAF and Judgment Recovery files.
  • Prepare reports for senior management, Claim Committee and regulators as required.
  • Provide detailed analysis identifying trends and risk exposures.
  • Provide support to review and maintain the Claims Guides, Forms and Internal procedures.
  • Foster business relationships with external stakeholders and staff.
  • Lead key projects and work collaboratively with internal and external stakeholders.
  • Work both independently and in a team environment.
  • Perform other duties as assigned, in accordance with job responsibilities or necessary department/corporate objectives.

QUALIFICATIONS: 

  • Minimum 7 years automobile claims adjusting experience in Bodily Injury and/or Accident Benefits.
  • Strong knowledge of the automobile insurance regulatory environments in all the provinces and territories where FA operates.
  • Chartered Insurance Professional (CIP) Designation or Fellow Chartered Insurance Professional (FCIP) Designation.
  • Undergraduate Degree or Post-Secondary Diploma.
  • Certified Risk Manager (CRM) Designation is an asset.
  • Advanced proficiency in MS Office, Access, Excel and SharePoint.
  • Experience in Tableau is an asset.
  • Possess a creative, inquiring approach to problem solving.
  • Excellent communication, presentation, time management and organization skills.
  • Demonstrated record of accomplishment in working virtually, meeting deadlines and effectively working on multiple tasks under time constraints.
  • Detailed oriented. 
  • Strong interpersonal skills with the ability to work successfully within cross-functional teams.
  • Strong business ethics for handling business-sensitive or confidential information.
  • Proven ability to make independent judgements.
  • Must be willing to travel out-of-province within Canada if required.
  • Valid driver’s license.

 

Please send résumé to:

Facility Association

E-mail: careers@facilityassociation.com

This position qualifies under the Employee Referral Program. Facility Association is an equal opportunity employer.

Facility Association is committed to providing accommodation for people with disabilities. Applicants need to make their needs known in advance.

Please be advised that only those applicants who are selected for interviews will be contacted.