Accident Benefit Adjuster - Remote

MutualONE; London; Remote; CAD 60,000 - 75,000; Full time

Job summary

A leading insurance firm is seeking an experienced Accident Benefit Adjuster to join the claims team in a fully remote role within Ontario. This position involves managing a portfolio of Accident Benefits claims and requires a strong knowledge of SABS and related legislation. Candidates should have a relevant degree, a CIP designation, and at least 3 years of experience in claims handling. We offer a rewarding career with a comprehensive compensation package and opportunities for professional growth.

Benefits

Comprehensive compensation & benefits package

Training and career advancement opportunities

Supportive work environment with a healthy work-life balance

Qualifications

• Minimum of 3 years of experience handling Accident Benefit claims.
• Familiarity with HCAI, medical assessments, and application of case law required.
• Experience in a mutual insurance company environment is an asset.

Responsibilities

• Manage a caseload of Accident Benefit claims from initial notice to resolution.
• Assess and investigate claims, including coverage verification and documentation.
• Negotiate and settle claims while ensuring fair outcomes.

Skills

Knowledge of SABS and Ontario insurance legislation

Organizational and time management skills

Analytical thinking and problem-solving skills

Communication and interpersonal abilities

Empathy and professionalism

Proficiency in claims management software

Ability to work independently and in a team

Continuous learning

Education

University Degree or post-secondary education related to insurance

Completion of Chartered Insurance Professional (CIP) designation or enrollment

Tools

Claims management software

Microsoft Office Suite

Job description

Overview

MutualONE Insurance Company is seeking an experienced Accident Benefit Adjuster to join our claims team in a fully remote role (within Ontario). Reporting to the Manager of Claims Services, you will manage a portfolio of Accident Benefits claims in accordance with the Statutory Accident Benefits Schedule (SABS) and other legislative requirements. This role is ideal for someone who is empathetic, detail-oriented, and committed to helping injured persons navigate the claims process fairly and efficiently.

Responsibilities

• Manage a caseload of Accident Benefit (AB) claims from initial notice to resolution, ensuring timely and appropriate claims handling
• Assess and investigate claims, including coverage verification, file documentation, and coordinating independent assessments and medical reports
• Apply the SABS and associated legislation, guidelines, and case law consistently and effectively
• Communicate empathetically and professionally with claimants, healthcare providers, legal counsel, and third-party vendors
• Negotiate and settle claims where appropriate, while ensuring fair outcomes for members and compliance with regulatory frameworks
• Maintain accurate records and detailed claim notes in the claims management system
• Participate in regular file reviews and contribute to continuous improvement initiatives in claims practices
• Stay current with legislative and regulatory changes affecting AB claims in Ontario

Desired Competencies

• Strong knowledge of SABS and Ontario insurance legislation
• Excellent organizational and time management skills, with the ability to prioritize and multitask
• Sound judgement, analytical thinking, and problem-solving skills
• Exceptional communication and interpersonal abilities, with a member-first mindset
• Demonstrated ability to handle sensitive situations with empathy and professionalism
• Proficiency in claims management software and Microsoft Office Suite
• Ability to work both independently and collaboratively within a team environment
• Continuous learner with a commitment to professional development

Qualifications

• University Degree or post-secondary education related to insurance
• Completion of Chartered Insurance Professional (CIP) designation or enrollment in the program
• Minimum of 3 years of experience handling Accident Benefit claims
• Familiarity with HCAI, medical assessments, and case law application is required
• Experience in a mutual insurance company environment is a strong asset
• Criminal Records Check will be required

This role requires the individual to reside in Ontario.

What we offer

We are an equal opportunity employer offering:

• A rewarding career and comprehensive compensation & benefits package
• Training, education, and career advancement opportunities
• A work environment that is fun and friendly and supports a healthy work-life balance

At MutualONE, your efforts will always make a difference!

Interested? We want to hear from you!

We thank all applicants for their interest; however, only those considered for an interview will be contacted.

No phone calls or agencies please.

Accessibility and Human Rights

ACCESSIBILITY STATEMENT (AODA IN ONTARIO): MutualONE is committed to providing a barrier-free work environment in concert with the provincial guidelines for accessibility (Accessibility for Ontarians with Disabilities Act and the Ontario Human Rights Code, Ontario Only). As such, MutualONE will make accommodations available to applicants with disabilities upon request during the recruitment process.

HUMAN RIGHTS STATEMENT: MutualONE strives to ensure that its employment practices are free from direct and indirect discrimination and is committed to upholding the human rights of those participating in the hiring process. MutualONE will not condone or tolerate any acts of discrimination or harassment under any grounds protected by human rights legislation. This commitment extends to the hiring process and throughout the course of employment.