Adjuster

Updated:
Apr 02, 2025 - The Adjuster provides oversight and management of non-litigated crew claims across all brands, evaluates legal exposures, and sets reserves for claims. This position engages directly with claimant's attorneys, negotiates settlements, and supports legal counsel in the defense of litigated claims, including attending mediations. This role manages complex technical claims adjudication and ensures exceptional customer service across various communication channels, fulfilling service level agreements and departmental performance indicators.

Job Summary:

• Deliver and exceed on all key performance indicators as it relate to the total amount of recovery dollars, the percentage of total outstanding recoveries, file closures, claims leakage control and expense management.
• Evaluate and review subrogation referrals, complete liability investigations, and review coverages and documentation necessary for a successful recovery.
• Evaluate liability issues based on theories of negligence, legal principles, and responsibilities under prevailing law.
• Obtain prompt and reasonable settlement recoveries directly with policyholders and third parties or through external resources.
• Work with and direct external vendors (legal, independent adjusters, engineers) to ensure prompt and considerable recoveries while controlling expenses.
• Work with all claim departments, in both Personal and Commercial Lines (Automobile, Property, Marine, Equipment Breakdown/Boiler and Machinery, etc.) nationally within all ROINS companies.
• Mentor junior adjusters to enhance knowledge and support our development strategy of promoting from within.
• Monitor and identify training and industry trends that may affect recovery strategies and work with the Leadership Team inappropriate planning.
• Deliver astounding customer service to brokers, customers and colleagues.
• Contribute to the team success by consistently leveraging RSA best practices.

Skills on Resume:

• Analytical Skills (Hard Skills)
• Legal Knowledge (Hard Skills)
• Negotiation Skills (Soft Skills)
• Mentorship and Training (Soft Skills)
• Customer Service Orientation (Soft Skills)
• Adaptability to Industry Trends (Soft Skills)

Job Summary:

• Obtain details of the loss through investigation over the telephone and/or independent adjuster, medical and private investigation.
• Interpret coverage and legal regulations in the adjudication of automobile injury claims for Ontario, Alberta, Nova Scotia, New Brunswick and Newfoundland.
• Ensure proper and timely reserving and payments up to $100,000.
• Ensure timely reporting of file exposures to the Supervisor on a scheduled basis.
• Liaise with policyholders and other professional service providers on the assessment, delivery and payment of claims by telephone, writing, etc.
• Adhere to customer satisfaction standards to contribute to increased customer retention and reduction of severity in all areas of claims.
• Responsible for working knowledge of policy management systems, Microsoft Word, Excel and Outlook.
• Investigate, negotiate, and settle large Property and BI claims.
• Maintain long-lasting relationships with our policyholders
• Work comfortably in a fast-paced work environment

Skills on Resume:

• Coverage Interpretation (Hard Skills)
• Reporting Skills (Hard Skills)
• Communication Skills (Soft Skills)
• Customer Service (Soft Skills)
• Technical Proficiency (Hard Skills)
• Relationship Management (Soft Skills)

Job Summary:

• Investigating, negotiating and agreeing settlement of claims in a professional manner
• Liaising with insured, insurers and brokers to achieve professional and timely conclusion of claims
• Completing both on-site and desktop investigations
• Producing reports in compliance with professional standards and internal guidelines in accordance with agreed timescales
• Actively contribute towards business development programme
• Network, identify and facilitate opportunities for business growth
• Undertaking projects and other ad hoc work
• Listen, define, write, explain, and interpret ideas and policies
• Handle difficult and stressful situations with professional composure
• Analyze, organize, and prioritize work while meeting multiple deadlines

Skills on Resume:

• Negotiation Skills (Soft Skills)
• Reporting Skills (Hard Skills)
• Networking Skills (Soft Skills)
• Project Management (Hard Skills)
• Communication Skills (Soft Skills)
• Stress Management (Soft Skills)
• Organizational Skills (Hard Skills)

Job Summary:

• Responsible for the day-to-day claims adjudication of assigned claims.
• Conduct investigations to determine and document claim compensability in accordance with Claims Department Guidelines.
• Establish proper and timely reserves.
• Properly document all activity conducted in the management of assigned claims.
• Make timely 3-point contact of interested parties.
• Direct all facets of vendor assignment in managing the final outcome of the claims process.
• Work in compliance with the…