Claims Examiner

Kaufman Claims is seeking an experienced Claims Examiner to manage a portfolio of property and marine claims in a third-party administrator (TPA) environment. The successful candidate will bring hands-on Inland Marine and/or Ocean Marine claims examining or adjusting experience, together with a strong property claims background.

This role owns files from assignment through resolution. You will analyze coverage, develop claim strategy, direct independent adjusters and other experts, maintain accurate reserves, prepare clear reports and recommendations, and provide proactive service to insurer, Lloyd's market and distribution partners. This is an opportunity to join a growing specialist claims organization backed by the global resources of H.W. Kaufman Group.

• Proactively manage a portfolio of property and Inland/Ocean Marine claims across Canada in accordance with client instructions, service standards, delegated authority and applicable regulatory requirements.
• Review policy wordings, endorsements, exclusions and claim facts; identify coverage issues; and prepare timely coverage analyses, status reports, reservation of rights letters and declination or denial correspondence, as appropriate.
• Establish an investigation and resolution strategy for each file, including clear action plans, diary dates and next steps.
• Appoint, direct and oversee independent adjusters, marine surveyors, engineers, accountants, restoration contractors, legal counsel and other experts.
• Evaluate cause, damage, liability and quantum; review estimates, inventories, repair documentation, proof of loss forms and expert reports; and challenge unsupported findings or costs.
• Set, review and maintain appropriate loss and expense reserves. Prepare reserve and settlement recommendations for matters that exceed delegated authority.
• Communicate promptly and professionally with insurers, Lloyd's brokers and managing agents, underwriters, retail and wholesale brokers, managing general agents, insureds, claimants, adjusters and counsel.
• Negotiate fair, well-supported settlements within authority and obtain client approval when required.
• Identify and pursue salvage, subrogation and other recovery opportunities, where appropriate.
• Maintain complete, accurate and audit-ready file documentation while meeting reporting, diary and service-level requirements.
• Escalate complex coverage, litigation, reputational or large-loss issues promptly and contribute to file reviews, audits and process improvement.

• 7+ years of progressively responsible claims examining or adjusting experience. Candidates with 5+ years of highly relevant complex property and marine claims experience may also be considered.
• Demonstrated hands-on experience with Inland Marine and/or Ocean Marine claims, including cargo, transit or related specialty marine losses. Experience across both is strongly preferred.
• Strong property claims background, ideally including both commercial and residential losses.
• Advanced ability to read, interpret and apply policy wordings and to communicate defensible coverage positions in writing.
• Experience directing external adjusters and experts and managing files in an insurer, TPA, independent adjusting or Lloyd's market environment.
• Sound judgement in investigation planning, reserve setting, negotiation, settlement and escalation.
• Excellent written and verbal communication skills, including concise insurer reporting and sensitive client and customer communications.
• Ability to manage a full caseload, competing priorities and strict deadlines through a disciplined diary system.
• Strong attention to detail, organization, analytical thinking and follow-through.

• Post-secondar…