Senior Claims Examiner in Toronto

Senior Claims Examiner in Toronto

Toronto Full-Time On-site
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Our client, a well-established Canadian liability insurer, is looking for a Claims Examiner to join its claims team on a contract basis. This is a hands-on, self-directed role for someone who can step in and be productive from day one.

Retired or semi-retired professionals who are open to returning for a defined term, are encouraged to apply.

About the Role

You'll manage a portfolio of complex, often litigated liability files. You are the decision-maker on each claim: you direct adjusters and defence counsel, set reserves, and control negotiations through to settlement or defence.

Key Responsibilities

  • Review initial claim documentation, confirm coverage, apply legal and claims analysis, and set and amend reserves
  • Instruct adjusters and defence counsel on an ongoing basis and make settle/deny/defend decisions
  • Ensure evidence and information are properly collected and preserved
  • Authorize mediation and pre-trial expenses, and represent the organization at mediations and pre-trials
  • Lead negotiations with plaintiff counsel, mediators, pre-trial judges and claimants
  • Make settlement decisions up to the posted reserve and authorize payments
  • Handle complex and specialty files, including serious injury, surgical and medical liability matters, privacy breaches and class actions
  • Interpret policy wording and provide analysis and recommendations on non-claim matters
  • Provide guidance on general risk management questions and work with internal risk and insurance teams
  • Liaise with Finance to verify transactions
  • Train junior staff and present on claims matters when required

What We're Looking For

  • 5-10+ years of liability claims experience, with a strong working knowledge of CGL, occupiers' liability and litigated files
  • Solid understanding of the litigation process: statements of claim, mediation and pre-trial preparation
  • Sound judgment, analytical thinking and common sense. You can read a policy, confirm coverage, set a reserve and defend your reasoning
  • Comfortable challenging counsel's recommendations when needed
  • Clear, concise written and verbal communication, including the ability to summarize complex reports in a few words
  • CIP, FCIP and/or CRM completed or in progress
  • Professional liability or medical malpractice experience is an asset, but not required
  • Experience at an insurer, independent adjusting firm, or a self-insured organization will be considered
  • Advanced Microsoft Office skills (Outlook, Word, Excel)
  • Valid G driver's licence and access to a vehicle

Details

  • Contract: approx.12 to 15 months
  • Location: Toronto area, hybrid (2 days per week in office)
  • Hours: Monday to Friday, 8:30 AM to 4:30 PM
  • Compensation: $75 000 to 120 000 Depending on experience can be examiner or Senior examiner level.

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Senior Claims Examiner in Toronto employer: DGA Careers Inc.

As a major Canadian insurance carrier, this company offers an exceptional opportunity for the AVP, Marine role, allowing you to build a national Marine practice from the ground up. With a strong focus on autonomy and growth, you'll have the resources of a well-capitalized insurer at your disposal, alongside competitive compensation, generous vacation, and a comprehensive benefits package. The work culture promotes collaboration and visibility, ensuring that your contributions are recognized and impactful in shaping the future of Marine underwriting in Canada.

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Contact Details:

DGA Careers Inc. Recruitment Team