Multiline Claims Specialist investigating and resolving multiline insurance claims with a focus on member satisfaction. Collaborating with internal and external stakeholders within a hybrid work environment.
Responsibilities
Investigate and evaluate claims across multiple lines of business (property, auto, and liability)
Review claim documentation, policy wording, endorsements, and supporting evidence to confirm eligibility and compliance
Communicate with claimants, insureds, witnesses, brokers, and third parties to gather required information and explain claims processes and decisions
Negotiate settlements in accordance with policy provisions and delegated authority
Identify claims requiring escalation, litigation, or external expertise and provide recommendations to management and legal counsel
Participate in litigation support activities, including file preparation, consultations with counsel, and attendance at hearings where required
Handle Property, Liability, Accident Benefits and Bodily Injury claims as required
Provide technical guidance and interpretation of policy coverage, exclusions, and conditions to ensure consistent claims handling
Review and analyze complex or escalated claims files to ensure adherence to internal standards, regulatory requirements, and best practices
Support consistency in reserving practices and submit claim liability information to actuarial or leadership teams as required
Assist in resolving claims-related complaints and appeals requiring advanced technical review
Act as a resource for staff on coverage interpretation and adjusting practices, including property, auto, and liability claims
Review claims processes, procedures, and workflows to identify opportunities for efficiency, accuracy, and quality improvement
Ensure claims handling aligns with company policies, procedures, and applicable legislation and regulatory standards
Prepare reports and analyze claims data to support monitoring, quality assurance, and management decision-making
Contribute to training initiatives, documentation, and knowledge sharing related to complex claims handling and policy interpretation
Requirements
Post-secondary education in insurance, business, or a related field
Minimum 5–7 years of progressive experience in multiline insurance claims
Strong technical knowledge of insurance policy wording, coverage analysis, liability determination, and claims reserving
Experience handling complex, high-value, or escalated claims and supporting litigation-related activities
Familiarity with Ontario insurance legislation, regulatory requirements, and industry best practices
Knowledge of Ontario insurance legislation across multiple lines of business, including Property, Auto, Liability, and Accident Benefits
Professional insurance designation (e.g., CIP, FCIP, or working toward) is strongly preferred
Excellent analytical, communication, and negotiation skills
Claims Specialist managing various insurance claims for Caradoc Townsend Mutual Insurance Company. Investigating, evaluating, and resolving claims while ensuring compliance and quality assurance.
Claims Handler at Lassie assisting customers with their pet insurance claims in a hybrid work model. Evaluating claims, communicating with pet owners and improving claims processes.
Workers Comp Claims Specialist at National Interstate Insurance managing a large inventory of complex claims and conducting comprehensive investigations. Supporting decision - making processes for coverage and liability determinations while maintaining strong relationships with stakeholders.
Complex Property Claims Adjuster managing intricate personal lines claims via phone at Aviva Canada. Responsible for claim settlement and ensuring top - quality customer service excellence and cost management.
Claims Examiner for Workers Compensation analyzing and adjudicating complex claims for various jurisdictions. Working in a hybrid model from Plano, TX or remote for experienced professionals.
Claims Adjuster handling commercial claims for an innovative insurance startup utilizing real - time data. Collaborating with a global team and driving successful claims outcomes in a high - growth environment.
Claims Adjuster managing mid - and higher - level general liability claims for a global industry leader. Assessing liability, negotiating settlements, and maintaining professional client relationships.
Claims Processor assessing and logging drug requests for Canada Life in a fast - paced environment. Requires strong time management and organizational skills with a focus on customer service.
Senior Complex Claims Specialist at Hiscox optimizing claims handling and strategies for Construction Defect and Property Damage. Collaborating with legal teams and ensuring effective claims resolution processes.