Zurich NA Claims Specialist II in Toronto, Ontario

Claims Specialist II

Description

Job Summary

Handle auto bodily injury claims of low to moderate exposure and complexity within specific limits of authority by following established protocols to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service.

Job Qualifications

Basic Qualifications:

  • Juris Doctor and 2 or more years of experience in the Claims and Litigation area within the Insurance industry

OR

  • Bachelors Degree and 4 or more years of experience in the Claims and Litigation area

OR

  • High School Diploma or Equivalent and 5 or more years of experience in the Claims and Litigation area within the Insurance industry

OR

AND

  • Knowledge of the insurance industry, claims and the insurance legal and regulatory environment

  • Knowledge of claims handling or insurance legal statutes and procedures

  • Ability to interpret coverage on various liability policies

  • Customer service experience

Preferred Qualifications:

  • Analytical skills

  • Negotiation experience

  • 3 or more years of claims experience in line of business

  • Strong communication skills

  • Ability to multi-task and adapt to a changing environment

  • Organization and time management skills

  • Experience collaborating across work groups

  • Microsoft Office experience

Job Accountabilities

Key Accountabilities:

  • Document claims file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate exposure and complexity personal or commercial line claims.

  • Exercise judgement to determine liability by gathering and analyzing relevant facts; utilizing applicable law; establishing basic principles of negligence.

  • Exercise judgment to determine policy verification and coverage determination by analyzing applicable coverage for claims and determining whether the loss falls within the coverage.

  • Work to have a timely resolution to claims by developing case strategy; developing a case evaluation; escalating issues as appropriate.

  • Establish timely reserves and perform ongoing review throughout claims cycle within authority limit by estimating and validating value of claims.

  • Assess damages by calculating applicable damages or range of damages allowed by law.

  • Negotiate settlement of claim by establishing appropriate negotiation strategy and utilizing available tools and resources within authority limits.

  • Meet quality standards by following best practices.

  • Ensure customer service by proactively communicating information; responding to inquiries; following customer protocols and may participating in customer marketing efforts.

  • Manage expenses by working within vendor approved networks and managing scope of work assigned to outside contractors. Departs from approved vendors with manager approval, where in the best interests of the insured.

  • Ensure legal compliance by following state and federal laws and regulations and internal control requirements.

  • Refer claim to subrogation and fraud teams by identifying potential subrogation and fraud.

  • Contribute to profitable growth by providing risk insight, information and trends to Business Unit or customer as needed.

  • Protect Zurich’s reputation by keeping claims information confidential.

  • Maintain professional and technical knowledge by participating in educational opportunities, staying current with industry trends, establishing personal networks, and participating in professional societies.

  • Business Travel, as required

  • Extended Hours during Peak Periods, as required

  • Pass Applicable Exam/Licensing, as required

  • Regular Predictable Attendance

Additional Information

Imagine working for a company that truly cares about their employees, customers, stakeholders, and communities they serve. Imagine working for a values-driven organization that has the ambition and desire to be the best global insurance provider in the world. Zurich is that place where 53,000 employees across approximately 200 countries and territories are all focused on helping people and helping companies protect what is truly most important to them. We are a values-driven organization that takes pride in the work that we do every day and we have the ambition to be the best global insurer in the world.

Zurich is committed to providing a diverse, inclusive and barrier-free environment resulting in an accessible organization for employees, customers, and other parties who interact with, or on behalf of, Zurich. We strive to achieve a workplace free of discrimination of all forms, including discrimination on the basis of physical or mental disability, or medical condition. If you are interested in a job opportunity, please advise if you require an accommodation, so we can work with you to provide a more accessible process.

Primary Location: Canada-Ontario-Toronto

Schedule Full-time

Travel No

Job Posting 12/05/18

Unposting Date Ongoing

Req ID: 180009WR

It is the Policy of Zurich in North America, as an equal opportunity employer, to attract and retain the best-qualified individuals available, without regard to race/ethnicity, color, religion, gender expression, genetic information, national origin, sex, gender identity, sexual orientation, marital status, age, disability or protected veteran status.