Accident Claims Representative - lI

About Portage Mutual:
Where Your Talent Makes a Difference Imagine a workplace where your contributions are not only valued but also directly impact the lives of Canadians. At Portage Mutual Insurance, we’re more than just a trusted national property and casualty insurer—we’re a community of passionate individuals dedicated to serving our policyholders since 1884. Owned by our policyholders, we proudly offer competitive home, auto, commercial, and farm insurance products 100% through our broker network across Canada.

Join a company rooted in tradition, driven by innovation, and powered by a people-first culture.

Why Portage Mutual? At Portage Mutual, we believe that our people are our greatest asset. Here, you’ll find:

• Total Rewards:
  We care about your well-being and financial security. That’s why we offer a competitive salary, incentive plan, comprehensive health benefits, a pension plan and generous paid time off, including personal days.
• Career Growth & Development:
  Propel your career forward with access to diverse learning resources, tuition reimbursement for relevant programs, and bonuses recognizing your achievements in pursuing insurance designations.
• Flexibility:
  We support work-life integration by offering a flexible environment where you can choose to live wherever you prefer in Canada. Enjoy the freedom to select remote, in-office, and hybrid work arrangements that best suit your lifestyle.
• Inclusivity and Belonging:
  Be a part of a supportive and diverse team that embraces your unique perspective and empowers you to succeed. We’re dedicated to creating a workplace where every employee feels welcomed, valued and respected.
• Making a Difference:
  Find purpose in your career by aligning with an organization that shares your values and is committed to making a difference in the communities we serve.

Accident Benefits Claims Representative II

As an Accident Benefits Claims Representative – II, you’ll investigate, evaluate, reserve, negotiate and resolve assigned automobile accident benefits claims by:
Reviewing new losses, developing investigation plans, gathering statements, obtaining necessary documentation (medical records, authorizations, forms), and applying regulatory classifications accurately. Communicating with policyholders, treatment providers, investigators, accountants, and medical professionals to assess injuries, financial losses, and determine claim eligibility. Utilizing systems like HCAI, applying dispute resolution techniques, and leveraging structured settlements and independent medical exams to ensure fair and timely claim outcomes.

We’re looking for a detail-oriented, enthusiastic team player who embodies our company values and is committed to providing top-notch service.

• Review new losses, prepare an investigation plan, and contact the insured to discuss loss details.
• Work with policyholders to explain claims process in a clear and concise manner to ensure an efficient claims experience.
• Secure statements with policyholders, third parties, independent witnesses, passengers as necessary.
• Secure medical authorization, statutorily required forms, and medical opinions as necessary.
• Arrange appropriate independent medical examinations to aid in the assessment of coverage, injuries and damages.
• Assess the need and retain licensed investigators to assist in understanding injury severity.
• Work with accountants to assess income and other financial losses related to accident benefit coverages.
• Review complex policy wordings and legislation to assess coverage eligibility.
• Communicate verbally and in writing to policyholders and brokers coverage positions.
• Review complex medical forms and reports to determine benefit payment eligibility.
• Negotiate…