Senior Bodily Injury Examiner

April 19, 2024 by  
Filed under Jobs

Comma Recruitment are looking for a Senior Bodily Injury Examiner, responsible for the investigation, quantification, analysis, adjustment and settlement of complex property and casualty claims in excess of $250k

This role will focus on quality and customer service, by assessing and assigning the appropriate expert and vendor to each claim. The adjustment will be conducted in an efficient and effective manner to control the indemnity, spend and expenses without compromising the delivery of superior customer service. This includes establishing prompt relationships with insured members, detailed investigation of coverage, liability, and quantum, ensuring fiduciary and contractual compliance, and adhering to organization service standards, operational targets, and core competencies.

  1. Delivers a superior customer experience by responding to all general inquires, initiating and maintain contact with insured members, and assisting with commodity claims overflow.
  2. Responsible for confirming coverage for incoming claims by reviewing and compiling facts, obtaining technical reports from various parties as required, investigation of questionable claims, studying case law for liability and benefit determination, completing contractual coverage analysis, and assessing quantum, reviewing subrogation opportunities, negotiating, and resolving severity casualty matters.
  3. Maintains quality service and adheres to organizational standards while dealing with all aspects of file handling including reserving, expense and loss control, liability assessments, and creating defined disposition plans for future handling leading to file closure.
  4. Controls and directs work performed by outside experts, medical practitioners, lawyers, and service providers to completion.
  5. Represents stakeholders in a professional manner at meetings, court hearings, mediations, and other information gatherings forums with a view of resolution and/or settlement when appropriate.
  6. Maintains confidentiality of claims information at all times to protect operations and insured members.
  7. Responsible for data integrity, issuance of payments to vendors, insureds, and experts and for maintaining well-organized claim files while ensuring accuracy of data input.
  8. Adheres to partner’s guidelines, contracts, and insurance regulations to ensure legal and regulatory compliance.
  9. Actively participates in coaching and training sessions and collaborates with team members and management.
  10. Takes an active role in creating an environment of continuous improvement of work efficiencies and highlighting value work.

Performs other duties within competence, as assigned.

Comma Recruitment are looking for:

  1. CIP designation.
  2. Ability to hold an adjuster’s license.
  3. Thorough knowledge of the property and casualty industry
  4. 5+ years of experience in casualty claims handling including litigation file management; experience in handling losses more than $250,000 Residential construction experience an asset.
  5. Knowledge of medical rehabilitation concepts and medical
  6. Case law knowledge
  7. Superior investigation and negotiations skills
  8. Excellent communication skills verbal and written to effectively work with internal and external stakeholders.
  9. Superior organizational skills to manage competing priorities, including project management skills.
  10. Ability to learn and adapt in a fast-paced environment including working with various computer programs, databases, and software.
  11. Ability to work independently and as part of collaborative team environment.

Working Conditions:

  1. Hybrid Working Environment with consideration to hours of operations.
  2. May be required to work overtime / May be required to travel.

Please forward resume to [email protected]


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