Claims Specialist - Bodily Injury (Level 2 or 3)
Job title: Claims Specialist – Bodily Injury, Level 2 or 3
Job location: Remote
Join our team!
The Commonwell Mutual Insurance Group is not just another insurance company; we are a P&C Mutual company with solid grass roots within our community. We’re proud to be a leader within the P&C industry offering a Mutual experience rich with history, opportunity and exceptional customer service. We are committed to profitable growth, team development, ingenuity, while having fun at work. We encourage a work-life balance and we are serious about what we do.
The purpose of this position is to review, analyze, negotiate, and settle moderate to complex claims related to Property, Commercial, Liability and Auto losses including Accident Benefits. The incumbent is responsible for thoroughly investigating these losses where necessary, as well as assigning the appropriate independent adjuster and relevant experts to assist in the effective management and resolution of the claim. Supporting the technical development of their peer group through technical training and mentorship is also a key element of this role.
What you will do as a part of the team:
- Accountable for claims at all transaction levels including, coverage interpretation, evaluation, reserve adjustments, payments, written and verbal communication, expert requirements, and internal reporting requirements
- Consults as required for authority requests with respect to payments and incurred costs handling.
- Supports, where required, the Underwriting and Finance department on claim development, explanation and risk considerations
- Reviews claims queries and complaints and taking action where necessary
- Receives support, where required, in managing complex queries or complaints
What you will need to succeed:
- Completion of Post-Secondary Education and a minimum of 3-5 years of insurance experience, preferably in claims, is required
- Prior experience in customer service
- Ability to provide technical training and mentorship to Level 1 Claims, and Claims Support staff
- Working knowledge of reading and interpreting all relevant policy wordings
- Proficient understanding of other relevant regulations, including the Insurance Act, Occupiers Liability Act, Dog Owners Liability act and case law decisions requiring some support in interpretation
- Working knowledge of reinsurance restrictions of the reinsurance treaty
- Working comprehension of reserve calculation and exposure
- Working knowledge of how to assess future care costs, future loss of income and structured settlements
- Working understanding of how to review and interpret medical reports, clinical notes and insurer examination reports
- Proficient demonstration of interpretation and understanding of medical terminology and prognosis
- Working understanding of Ontario SABS Regulations
- Working towards, or completion of the CIP designation, and an active pursuer of the necessary education to respond to a changing marketplace
- Great organizational skills and ability to multitask is required
- Thorough attention to detail is a must to ensure accuracy of claims documents, policy coverage interpretation and recognition of financial exposure
- Ability to perform moderate mathematical calculations is required
- Effective communication skills: verbal, non-verbal and written
- Sound morals, ethics, and confidentiality with ability to develop trusting and effective working relationships with peers and employees
- Ability to exercise confidentiality and empathy are required when dealing with insureds and claimants
- Exceptional problem-solving skills and negotiation skills are required for this position
- Strong computer literacy including proficiency in all Microsoft Office programs and Internet navigation
Accommodations: The Commonwell is an equal opportunity employer committed to ensuring barrier free employment practices. Should you require workplace accommodation, please let us know, and we will work with you to meet your needs.