Claim Rep, Accident Benefits

Who Are We?

Solid reputation, passionate people and endless opportunities. That’s Travelers. Our superior financial strength and consistent record of strong operating returns mean security for our customers – and opportunities for our employees. You will find Travelers to be full of energy and a workplace in which you truly can make a difference.

Job Category

Claim

Target Openings

1

What Is the Opportunity?

Under close supervision, this position is responsible for investigating and evaluating, primarily low to moderate complexity claims, to determine coverage available to policyholders and claimants. This role is responsible for handling 1st party Personal Insurance and Business Insurance AB claims. The AB role handles a wide variety of causes of loss. In addition, the role applies policy, legislation and company guidelines to all claims to manage loss costs and customer relations. Occasionally the AB role handles claims with complexities related to unique coverage and/or damage issues. This position does not manage staff.

What Will You Do?

• Posting all reserves in system within file standards guidelines and updates system promptly as new information received
• Investigating and evaluating all relevant facts to determine coverage, damages and liability of first-party AB claims under a variety of policies
• Identifying and referring tasks to Travelers of Canada (Outside Adjuster), wherever complex claims are identified for immediate transfer to the appropriate level of Adjuster for special handling
• Reviewing and analyzing policy conditions, provisions, exclusions and endorsements pertinent to a variety of AB losses
• Documenting claims files in accordance with Best Practices
• Identifying potential for subrogation and refer appropriate claims to the Subro Unit
• Establishing timely and accurate claim and expense reserves
• Writing denial letters, Reservation of Rights and other complex correspondence to insureds
• Controlling damages through proper usage of cost containment tools
• Advises underwriting of any information gathered which may affect risk assessment
• Referring all files above settlement authority, with recommendations for resolution, to Unit Manager and follows up through closure
• Acting as primary contact for customer and as intermediary between customer and other parties
• Establishing accurate scope of damages for building and contents losses and utilize as a basis for written estimates and/or computer assisted estimates
• Explaining payment amounts to all customers by email or letter
• Participating in extended hours duties, as required
• Virtually handling inside claims from across the country; manage periods of increased claim volume
• Perform other duties as assigned.
• Meeting all quality standards and expectations per file standard guidelines
• Completing a level of investigation that is commensurate with the financial exposure on each loss handled
• Posts all reserves in system within Best Practice guidelines and updates system promptly as new information received
• Providing clear explanation of claims process and coverage to all customers
• Reviewing amounts on all invoices and all documentation supporting payments
• Working diary system to be proactive on files
• Negotiating and conveying claim settlements within authority limits to insureds
• Managing files in accordance with established Best Practices
• Managing pending and settles claims within company averages based on type of claim, complexity of claim and geographical area
• Returning all phone calls and emails within Best Practice guidelines
• Claim Practices and Field Support:
• Identifying and following up on all salvage and subrogation opportunities promptly
• Handling 1st party PI and BI AB claims of low to moderate severity and complexity as assigned
• Handling files in compliance with provincial regulations, where applicable
• Determining appropriate settlement amount based on independent judgment, computer assisted estimates, estimation of actual cash value and replacement value, appraisals, application of applicable limits and deductibles
• Managing file inventory to ensure timely resolution of cases
• Identifying and referring claims with Major Case Unit exposure to the Unit Manager
• Investigative Duties:
• Maintaining diary follow up on all files to ensure prompt disposition
• Occasional travel to other offices and provinces may be required
• Ensuring that all claims files and company information are kept confidential
• Obtaining and analyzing leases, contracts, by-laws and other relevant documents which may have an impact on the adjustment of losses
• Identifying and following up on all salvage and subrogation opportunities promptly
• Identifying and referring claims that may have valued added by an outside field inspection
• Conducting prompt investigation of coverage and liability
• Performing any other duties, as required
• Ensuring that all claims files and company information are kept confidential
• Providing excellent customer service to meet the needs of the insured, broker and all other internal and external customers
• Business Processes:
• Researching company experience/available case law to substantiate quantum, coverage and liability for casualty claims
• Making contact with insured within Best Practice guidelines
• Determining cases that may have fraud potential and to refer claims to Travelers Investigative Services

What Will Our Ideal Candidate Have?

• Math skills
• Ability to understand and apply policies and procedures
• Demonstrated ownership attitude and customer centric response to all assigned tasks
• Ability to deal with people and communicate effectively by telephone
• Excellent organizational skills with ability to work independently
• Generally, License(s) are required to be obtained within three months of starting the job
• High proficiency with Windows-based programs including spreadsheet and word-processing applications
• Hardware and software skills to utilize and leverage claim and estimating technology
• Solid analytical and decision making skills
• Enrolment in the CIP program is an asset
• Adjusters license as required, based on business needs
• University Degree/College Diploma or equivalent business experience preferred
• Proficiency in typing
• In order to perform the essential job functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with provincial and Travelers requirements
• Excellent negotiation skills
• Strong verbal and written communications skills
• Customer service orientation; empathy

What is a Must Have?

• A minimum of one year previous work experience required
• Licensing Required: In order to perform the essential job functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with provincial and Travelers requirements
• Must secure and maintain company credit card if required
• Experience utilizing computer technology; such as Microsoft Office, e-mail, Web-enabled applications, and database software required
• Ability to accurately compute a variety of numerical calculations required

What Is in It for You?

• Hybrid Work Arrangement : Employees in this position can split their time between working from home and a Travelers office.
• Wellness Program: The Travelers wellness program is comprised of tools and resources that empower you to achieve your wellness goals. In addition, our Life Balance program provides access to professional counseling services and other resources to support your daily life needs. Through Life Balance, you’re eligible for free counseling sessions with a licensed therapist.
• Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off (“PTO”) annually, plus the opportunity to purchase additional days to allow for up to a total of 36 PTO days per year. You will also receive twelve paid company Holidays.
• Health Insurance: Employees and their eligible family members – including spouses, partners, and children – are eligible for coverage from the first day of employment.
• Retirement: Travelers provides a core contribution of 3% of your total eligible earnings to your Deferred Profit Sharing Plan (“DPSP”). Travelers also matches your savings plan contribution dollar-for-dollar up to 5% of base pay.
• Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.

Equal Employment Opportunity Statement

Travelers is an equal opportunity employer. We are committed to providing accommodation to persons with disabilities. If you require accommodation during the recruitment or interview process we will work with you to accommodate your needs.

If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email ([email protected]) so we may assist you.