Sr Representative, Accident Claims

Definity is the parent company to some of Canada’s most long-standing and innovative insurance brands, including Economical Insurance, Sonnet Insurance, Family Insurance Solutions, and Petline Insurance. Our ambition is to be one of Canada’s leading and most innovative property and casualty insurers. We can’t do that without our people, so we embrace and encourage a culture that’s collaborative, ambitious, rewarding, and empowering.

We offer a flexible, hybrid work experience where employees work from the office and virtually depending on the type of work they are doing and who they are working with. Bring your true self and be a part of our journey. It’s better here.

This opportunity is well suited for an experienced Accident Benefits professional who thrives in a fast-paced environment and is committed to delivering exceptional customer service. Reporting to the Team Leader, Accident Benefit Claims, you will be responsible for managing a diverse and complex portfolio of claims, including income replacement, non-earner, caregiver, permanent impairment, and fatality benefits. Working closely with customers, healthcare practitioners, and other stakeholders, you will assess coverage eligibility, facilitate rehabilitation and recovery, and ensure claims are administered fairly, accurately, and in compliance with the Insurance Act and Care First principles.

• Report to the Team Leader, Accident Benefit Claims, while investigating, evaluating benefits, and administering the principles of Care First in accordance with the Insurance Act
• Securing details of claims by corresponding with customers, care practitioners, and/or representatives
• Regular communication with the customer and their health care practitioner(s)
• Assessing coverage eligibility and reviewing and applying interpretations of policy wordings in the resolution of coverage issues
• Applying applicable Priority Rules chart to each claim file
• Processing out of province and election of benefit claims
• Processing income replacement, non-earner, loss of studies, caregiver, permanent impairment, fatality, and other benefits
• Reserving files appropriately after assessing claim
• Maintaining detailed file records on an electronic claims system
• Processing payments after confirming benefits, eligibility and reserves
• Coordinating the most effective course of action for claims
• Confirming collateral benefits
• Responding to customer correspondence and forms in accordance with the applicable legislation
• Reviewing and approving, when appropriate, treatment plans for customer rehabilitation
• Arranging medical assessments as necessary and reviewing and relaying recommendations
• Other duties as assigned

• University degree in any discipline or a college diploma or the CIP designation
• Minimum of 4 years
  
  Claims handling experience
• Computer proficient in MS Word and Excel
• Professional, friendly and courteous in all interactions, whether with customers or co-workers
• Perform well in a busy operation and remain calm under pressure
• Team player adaptable to a changing environment
• Strong written and verbal communication skills

Salary Range:$59,300 - $109,200

Actual salary for the role may vary depending on work location of the successful candidate and other factors including but not limited to, skills, education, experience, working conditions and the local labour market.

This position is being posted to fill an existing vacancy.

Interested in this role, but don’t meet every requirement?

We’re actively seeking diverse backgrounds and perspectives to help us make insurance better. At Definity, inclusion, diversity, and equity aren’t just “nice to have” — they’re essential to our success.

• Hybrid work schedule for most roles
• Company share…