Senior Claims Adjuster, Accident Benefits

Claims / Indemnisation Toronto, Ontario

Position at Northbridge Financial Corporation

 “The Power of Together”

Join Northbridge, a growing dynamic company that has a long and rich Canadian history in providing innovative insurance solutions to customers nationwide.

Northbridge Financial Corporation is a leading commercial property and casualty insurance company that’s been helping protect Canadian businesses for more than 90 years. We’re 100% Canadian!

We offer a wide range of creative solutions to our customers through our Northbridge Insurance, TruShield Insurance and Federated Insurance brands where we strive to create a fair and friendly culture, upheld by the foundation of our five corporate values: respect, passion, connectedness, creativity, and excellence.

By continually striving to challenge the status quo, and by focusing on helping our customers, we’ve been able to build our reputation as one of Canada’s largest commercial insurance providers.

Be part of a team that’s passionate about making a difference every day, fuelled by our entrepreneurial spirit and where everyone owns a part of our success.

Located in the heart of Toronto’s Financial District, our head office is easily accessible by TTC and GO Transit, and within walking distance to the Eaton Centre and CN Tower. As a national property and casualty commercial insurance provider, we also have offices across Canada.

Position Summary 

The Senior Adjuster, Accident Benefits is responsible for providing efficient and prompt investigation, evaluation, negotiation, and settlement of claims in accordance with corporate guidelines and best practices.

What you will be doing:

  • Investigate, appraise/scope, confirm coverage, negotiate settlement and recovery, and conduct reporting and documentation of claims of moderate size and/or moderate complexity in accordance with established guidelines.
  • Conduct investigations of claims through contact with insurers, claimants, witnesses, other carriers, physicians, contractors, lawyers, etc.; identify and refer to more senior staff any cases beyond limits of personal authority, expertise, and functional jurisdiction
  • Evaluate, analyze and interpret policy wordings in order to determine coverage applicable to the loss; review and interpret available coverage, recognizing policy exclusions, and applying facts of loss
  • Based on established performance and guidelines, select, assign, and proactively manage service suppliers in the resolution of the claim with a view to controlling expenses while accurately assessing claimant indemnity entitlement
  • Create and implement an action plan for the resolution for each file; proactively manage all claims to conclusion through the use and ongoing maintenance of an effective diary (i.e., follow up) system
  • Ensure all incoming digital documentation is responded to promptly and within required timelines; ensure all phone messages are responded to promptly and within required timelines
  • Coordinate medical, income, and other necessary assessments and reviews
  • Determine and obtain the type of required documentation necessary to support claims in accordance with policy and legislation
  • Post necessary statistical data as required; prepare reports for internal and external parties
  1. Ensure the accurate and efficient payment of claims.
  • Review available information and establish, maintain, and recommend appropriate reserve, payment or recovery, negotiation, or declination
  • Enter and record claims, reserves, and payments
  • Process all payments promptly within guidelines and policy/statutory requirements
  1. Adhere to service standards by communicating effectively with all parties involved.
  • Establish and monitor litigation disposition plans
  • Attend and participate in meetings, LAT (License Appeals Tribunal) disputes, mediations, arbitrations, settlement conferences, pre-trials/trials
  • Participate in case law reviews
  • Foster productive business relationships with the Insured, all claimants, representatives, service providers and other carriers
  1. Monitor a dashboard for meeting SLA’s, deadlines and daily work.
  2. Ability to work in an Agile/open environment to discuss claims/service/ FAQ responses.
  3. Ability to use multi-channels to communicate with the customer and vendor partners.
  4. Ability to analyze the AB processes and refine according to claimant needs - effectiveness in obtaining complete information etc.
  5. Understand and apply best business practices towards compliance, internal control and operational risk controls in accordance to national standards and regulatory standards and policies.
  6. Work collaboratively with Supervisors and/or Managers on special projects and assignments when required.
  7. Other duties as assigned.

What we are looking for:

  • Post-secondary education and / or equivalent on the job experience
  • Minimum 4 years Accident Benefits Claims adjusting experience
  • Completed or actively pursuing CIP/FCIP designation
  • Working knowledge of Health Claims for Auto Insurance (HCAI) system
  • Ability to understand and interpret complex insurance contracts and changes in the interpretation as a result of case or statutory law; ability to assess liability and understand case law developments in the jurisdiction.
  • Working knowledge of principles and practices related to claims settlement, policy wordings, insurance contracts, fraud investigations, serious losses and coverage questions.
  • Intermediate proficiency with Microsoft Office (specifically Word and Excel)
  • Excellent communication (both oral and written) skills to explain processes and terminologies
  • Fluently bilingual (English / French) is a strong asset

What sets you apart:

  • Passionate about innovation and change by questioning the status quo to make a difference in the organization, insurance industry and in our customers lives.
  • Ability to work within and adapt to PC oriented environments, multi-channel handling including high proficiency with e-mail and web skills.
  • Strong analytical, problem-solving skills, investigative, and decision-making skills; demonstrated negotiation skills
  • Demonstrated report-writing skills
  • Demonstrated ability to work well as a team player or individual contributor; self-motivated
  • Ability to demonstrate patience, empathy and understanding in dealings with customers
  • Able to plan, organize, and manage multiple demands and changing priorities
  • Proficiency with Microsoft Office Suite (Word, PowerPoint, Excel)

What we have to offer: 

  • Northbridge Cares program – volunteer day and donation matching
  • Generous paid time off, including personal days. Flexible work hours as well as early departure opportunities
  • Flexible Group Benefits Plan – medical, dental, insurances
  • Defined Contribution Pension Plan + Optional Group RRSP
  • Northbridge Employee Share Purchase Plan
  • Education Assistance Program
  • Employee Assistance plan
  • Staff Insurance - discount on home, automobile and pet insurance
  • Plus, the opportunity to contribute to the success of Northbridge through sharing your knowledge and experience while learning from others!

Application Process:

Northbridge welcomes and encourages applications from people with disabilities. Accommodations are available upon request for candidates taking part in all aspects of the selection process. Interested, qualified candidates are encouraged to apply.

All offers of employment are conditional upon satisfactory background and reference checks, including a criminal record check, credit check, and employment and educational verifications.