Claims Processor evaluating and processing pet insurance claims for Pets Plus Us across Canada. Reviewing veterinary histories, policy eligibility, coverage, and compensation decisions.
About the role
- Claims Representative investigating Auto Insurance claims for fair settlements. Responsible for fraud detection, liability determination, and communication with clients and legal parties.
Responsibilities
- Coordinate investigations into potential fraud, misrepresentation, and/or exaggeration within Auto Insurance claims
- Collect evidence and analyze information to determine liability and coverage, including damage valuations, statements and examinations under oath (EUO), expert reports, customer and claim-related documents, witness testimony, police reports, and all other information required to clarify and/or justify a claim
- Identify fraud indicators and effectively coordinate investigative, vendor and legal resources to validate indicators and make decisions on liability and coverage
- Communicate in a timely and respectful manner with customers, claimants and lawyers when making decisions on coverage, reporting findings, and settling claims
- Handle disputes and payments into court, interpret case law and legal opinions, and pursue fair and equitable resolutions to customer disputes, complaints and escalations
- Negotiate settlements fairly and equitably
- Participate and/or lead project work, by working with members of the Investigative Services and Claims departments to deliver on project goals
- Ensure all claims and investigations are clearly documented and meet all legislative requirements
Requirements
- A minimum of 2 years claims adjusting experience in Auto Damage insurance
- Knowledge of provincial insurance act, Ontario Auto policy
- Experience with and/or knowledge of the legal dispute process for insurance claims
- Strong analytical, negotiation, and decision-making skills
- Strong communication and time management skills
- Exceptional written and verbal communication skills
- A friendly and can-do attitude
- University degree or college diploma and/or equivalent business experience
- Completed, or are working toward, Chartered Insurance Professional (CIP) designation
- Ability to be problem-solve and innovate investigation strategy
- Additional investigation experience in the insurance and/or financial industry
- Bilingualism in English and French and/or any other language
Benefits
- Flexible work arrangements and a hybrid work model
- Possibility to purchase up to 5 extra days off per year
- Multiple benefits offered to support physical and mental wellbeing, including telemedicine, Wellness account and much more
- Share plan & other savings: up to 12% of salary or even more (ask how you could earn guaranteed income for life)
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