Full-Time Claims Representative, Intermediate, Accident Benefits (Special Handling Unit)
Job Description
//
We are presently looking for eager individuals to join our Special Handling Unit. This team takes referrals from internal claims teams on files where a more detailed approach is considered to be appropriate. Adjusters in this team work closely with our Special Investigation Unit.
You will:
1. Investigate routine and moderately complex losses by phone and written correspondence. Ensure prompt and equitable settlements in line with corporate policies and standards. Evaluate each claim assigned and establishes claim reserves. Develop an action plan for conducting investigations including identification of additional needs [i.e. – an independent medical examination, the claimant’s prior medical or employment history] and determining necessary contacts, interviews and/or other information required to clarify and justify the claim.
2. Thoroughly investigate all claims submissions relative to Property and Accident Benefits including applications for medical and rehabilitation and Specified Benefits through utilization of personal investigative skill sets as well as internal and external investigative resources. Maintain effective communication channels with claims departments and liaise with adjusters, special investigative experts, management, and other claims representatives on technical and investigative issues.
3. Document the claim file by collecting and securing appropriate reports and statements from third-party adjusters, claimants, insureds, witnesses and any other pertinent experts to determine liability and coverage. Analyze the information gathered, interpret insurance policy wordings, determine coverage, and assess damage and/or liability. Determine when sufficient information has been gathered to close the investigation.
4. Within established authority limits, negotiate with insureds, claimants, lawyers, and insurers to settle claims. Compose claims reports to outline findings and settlements. Place the I.C.P.B. on notice. Evaluate the injury’s value and complete A.B. assessment forms. Use abeyance system to monitor file’s status and development. Complete internal reports [i.e. – 30 day reports, 90 day reports]
5. Maintain productive business relationships with service providers. Monitor performance to ensure compliance with professional and corporate standards.
Skills:
//
Education:
•University degree/college diploma preferred or equivalent business experience.
Experience:
•Experience in Accident Benefits Claims
•Strong attention to details and ability to identify, evaluate and problem solve issues
•Good written and verbal communications skills
•Proven customer service skills
•Ongoing commitment to self-development (i.e. CIP participation)
How to Apply
Please send your resume to rupa.prakash@intact.net1286 total views, 1 today
