Casualty Claims Adjuster II

Job Responsibilities

• Investigate automobile bodily injury claims to support prompt, fair resolution
• Make independent decisions, assess risk, think critically, and prioritize effectively
• Review and analyze medical records, police reports, expert reports, and other documentation
• Represent the company in negotiations and settlements with third parties, claimants, and legal counsel
• Manage claims through litigation where required
• Maintain complete, accurate, and timely claim file documentation
• Set, review, and manage loss and expense reserves
• Evaluate settlement criteria and authorize payments according to policy, legislation, authority levels, and best practices
• Communicate professionally and empathetically with customers, brokers, service providers, lawyers, healthcare professionals, and other stakeholders
• Collaborate with Claims Assignment, Collections, Underwriting, Appraisal, Legal, and other internal departments
• Manage a high-volume workload while maintaining quality, accuracy, service standards, and urgency
• Transition to the Care First Team with a health- and recovery-focused approach
• Assess eligibility and entitlement for accident benefits using policy provisions, legislation, medical information, and evidence
• Review medical information and medical terminology related to injuries, treatment needs, functional limitations, and recovery goals
• Support injured customers through complex situations and help them navigate recovery
• Collaborate with healthcare providers, rehabilitation professionals, employers, legal representatives, and other recovery stakeholders
• Identify opportunities for early intervention and appropriate support
• Develop technical knowledge through training, coaching, feedback, and professional development

• Minimum of two years of experience handling casualty claims, preferably involving automobile bodily injury
• CIP designation preferred, or demonstrated commitment to pursuing one
• Post-secondary education in a health-related discipline, insurance, business, or related field is an asset
• Experience with medical terminology or in a healthcare, rehabilitation, disability, or medical setting is an asset
• Strong written and verbal communication skills
• Strong investigative, analytical, and critical-thinking skills
• Ability to make well-reasoned, evidence-based decisions using medical, policy, and claim-related information
• Strong negotiation and conflict-resolution skills
• Ability to de-escalate difficult conversations and remain calm and professional in stressful situations
• Strong system navigation skills and ability to use technology efficiently in a high-volume environment
• Growth-oriented attitude and openness to coaching, feedback, continued learning, and changing business processes
• Candidates must be eligible to work in Canada from the anticipated start date and throughout employment

Demonstrates expertise in investigating automobile bodily injury claims, managing high-volume workloads, and effectively communicating with various stakeholders. Proficient in analyzing medical records and applying policy provisions to support fair claim resolutions.

• Automobile Bodily Injury Claims Handling
• CIP Designation
• Medical Terminology Proficiency
• Negotiation and Conflict Resolution
• Analytical and Critical Thinking Skills

• Claims Management
• Risk Assessment
• Evidence-Based Decision Making
• Settlement Evaluation
• Documentation Management

• Strong Communication Skills
• Empathy
• Problem-Solving
• Stress Management
• Growth-Oriented Attitude

• CIP Designation

• Casualty Claims
• Healthcare
• Rehabilitation
• Disability
• Insurance

• Claims Assignment Systems
• Technology Proficiency