Liability Claims Specialist

Comma Recruitment is looking for a talented CGL and BI Claims Specialist with 5+ years progressive claims expertise.

This position is responsible for investigating, negotiating and settling serious CGL and bodily injury claims. The adjuster will be responsible for direct file handling and communication with all involved parties.

Role & Responsibilities include :

• Confirm valid coverage.
• Fully investigate liability losses.
• Fully investigate serious injuries & exposure.
• Provide instruction and direction to internal and external vendors i.e.: Adjusters, Legal Counsel, Engineers.
• Calculate ultimate probable exposure and reserve accordingly.
• Maintain a proactive diary system to monitor files.
• Ensure files are up to date with reserve worksheet, case law, medical and liability information.
• Mentor and coach junior adjusters.
• Prepare Major Loss/Reinsurance Reports and participate in Claims Committee process.
• Comply with service standards as outlined in Best Practices
• Actively participate in settlement initiatives along with both private and mandatory mediations.

 

Comma Recruitment is looking for the following knowledge, Skills and Attributes:

• Knowledge of regulatory and contractual obligations, medical terminology, vocational rehabilitation concepts and dispute resolution practice.
• Experience with internal and external audits.
• Detail oriented and well-organized individual.
• Strong oral and written communication skills.
• Travel to mediations/pre-trials/trials is required.
• Superb interpersonal skills and leadership qualities/potential.
• Work well individually or as a part of a team.
• Computer literacy with strong working knowledge of Microsoft programs.

Education and Experience:

• Minimum 5 years of experience adjusting CGL & BI claims
• CGL experience ideally to include a strong background in coverage (duty to defend vs. indemnify), product liability, occupier’s liability, and environmental losses.
• Experience in Municipality losses and construction wrap up an asset.
• University or College Degree
• CIP designation or working towards one

Please forward resume to [email protected]

Property Claims Adjuster

Comma Recruitment are looking for a talented Property Adjuster who can deliver a superior customer experience which includes responding to all general inquires, initiating and maintain contact with insured members, and assists with commodity claims overflow.

Confirm coverage for incoming claims by reviewing and compiling facts, obtain technical reports from various parties as required, complete contractual coverage analysis and assessing quantum, review subrogation opportunities, negotiating and resolving property insurance claims of minor to moderate nature in a timely manner.

Coordinate, direct and follow up on work activities performed by outside service providers to completion. This includes contractors, engineers, contents specialist and other suppliers as required.

Ensure all correspondence is completed in a time efficient/effective manner including the creation of Critical Path, Proof of Loss, waivers and reservation rights letters.

Gather information from insured members, civil authorities, police, witnesses and other insurers to complete a timely investigation of property loss.

Maintain quality service and adheres to organizational standards to deal with all aspects of file handling including reserving, expense and loss control, questionable claims, and creating defined disposition plans for future handling leading to file closure.

Assist and participate in all dispute forums related to policy coverage on behalf of key stakeholders. Provide support and assembles documentation on items in dispute along with resolution recommendations.

Participate as necessary in the legislated Property Appraisal Process to resolve quantum disputes during claim file negotiations.

Identify by law requirements and standard unit definitions of each provinces Condominium policies.

Coordinate effectively with the Condominium corporation on insured losses to ensure effective restoration and repairs. Keep claims information confidential to protect operations and insured members.

Responsible for data integrity, issuance of payments to vendors, insureds and experts and to maintain well-organized claim file while ensuring accuracy of data input.

Adhere to guidelines, contracts, and insurance regulations to ensure legal and regulatory compliance.

Actively participate in coaching and training sessions and collaborate with team members and management.

Take an active role in creating an environment of continuous improvement of work efficiencies and highlight value work. Become an active Member of our National Catastrophic Response Team

Comma Recruitment are looking for :

A post-secondary education and/or college diploma within related field.

CIP designation or working towards designation.

A provincial adjusters license; Ability to acquire same.

2+ years’ experience with a good understanding of the various property policies.

Excellent communication skills verbal and written to effectively work with internal and external stakeholders.

Strong time management and organizational skills to manage competing priorities.

Current Microsoft Office working knowledge.

Ability to learn and adapt in a fast-pace environment including working with various computer programs, databases and software.

Ability to work independently and as part of collaborative team environment.

 

Additional Information

Some of the Perks We Offer:

We offer best-in-class pension and benefits; total reward programs and comprehensive mental wellness supports to set you up for every success in and outside of work.

Rewarding salary and bonuses that truly value your dedication

Industry-leading group benefits with 100% premium coverage (excluding LTD) that start on your first day

Defined benefit pension plan for a financially confident retirement

100% coverage of approved continuing education and licensing fees (including RIBO courses in Ontario)

Access to a wealth of learning resources, including LinkedIn Learning for professional development

Flexible work-from-home and hybrid options

Unlock your potential with opportunities for advancement

 

Please forward resume to [email protected]

Clinical Coordinator – GTA with hybrid flexibility

Comma Recruitment are seeking a highly skilled and experienced Clinical Coordinator to join our team. The Clinical Coordinator will play a key role in facilitating the IME process, liaising with insurance companies, and ensuring the smooth operation of medical examinations. The ideal candidate will have a strong background in clinical coordination, experience with catastrophic impairments, and proficiency in software such as Smartsimple or IME Workflow.

Responsibilities:

• Coordinate and schedule independent medical examinations (IMEs) with healthcare providers, claimants, and insurance adjusters.
• Act as the primary point of contact for insurance companies, providing updates, addressing inquiries, and ensuring client satisfaction.
• Review medical records and reports to assess the severity and extent of catastrophic impairments.
• Collaborate with healthcare professionals to gather necessary documentation and information for IMEs.
• Utilize software platforms like Smartsimple or IME Workflow to manage and track examination requests, appointments, and reports.
• Ensure compliance with regulatory requirements and company policies throughout the IME process.
• Assist in the preparation and distribution of comprehensive medical assessment reports to insurance clients.
• Provide administrative support as needed, including data entry, file maintenance, and invoice processing.

Qualifications:

• Bachelor’s degree in a relevant field (e.g., healthcare administration, nursing) preferred.
• Proven experience in clinical coordination, preferably in a medical examination or insurance setting.
• Familiarity with catastrophic impairments and the associated medical documentation and terminology.
• Proficiency in using software platforms such as Smartsimple or IME Workflow for scheduling and workflow management.
• Excellent communication and interpersonal skills, with the ability to effectively interact with healthcare professionals, clients, and colleagues.
• Strong organizational skills and attention to detail, with the ability to manage multiple tasks and deadlines simultaneously.
• Ability to work independently and collaboratively in a fast-paced environment.
• Commitment to maintaining confidentiality and adhering to ethical standards in all aspects of work.

Please forward resume to [email protected]