Claims Representative II, Accident Benefits

Co-operators General Insurance Company; Hamilton; Hybrid; CAD 61,000 - 101,000; Full time

Benefits offered by this job

Training and development

Flexible work options

Well-being programs

Volunteer days

Job summary

Co-operators General Insurance Company in Hamilton, Ontario, is seeking a Claims Representative II to investigate, negotiate, and resolve complex Accident Benefits claims. You will work with clients and providers to develop effective case plans and ensure high-quality service.

With 3+ years in P&C liability claims, you will handle challenging files, collaborate across disciplines, and support the team through coaching and technical guidance.

Qualifications

• 3+ years of P&C liability claims handling or related insurance experience.
• Post-secondary degree or diploma required; CIP or Medical Rehabilitation designation encouraged.
• Passion for customer-centric problem solving with strong priority management.
• Knowledge of accident benefits coverage and provincial adjuster licensing is an asset.

Responsibilities

• Investigate, interpret coverage, negotiate, and resolve complex AB claims.
• Collaborate with clients, physicians, treatment providers, employers and rehab workers on case plans.
• Manage complex files in defense litigation and ADR.
• Coach, train, and provide technical support to the claims team.
• Deliver exceptional client service aligned with claims standards and quality expectations.

Skills

P&C liability claims

Client service

Communication

Priority management

Negotiation

Education

Post-secondary degree or diploma

Job description

Company: CGIC
Department: Accident Benefit Claims
Employment Type: Regular Full-Time
Work Model: Hybrid (2 days in office)
Language: English is required, French is an asset.
Additional Information: This/these role(s) is/are currently vacant

The Opportunity:

We are a leading Canadian financial services co-operative committed to being a catalyst for a sustainable and resilient society and our team is essential to deliver on this strategy. That’s why we prioritize our people, to ensure we provide a strong culture and development opportunities which enables our team to thrive and to live our purpose. The best part is that you will work with people that care passionately about you, our clients and our communities.

As a Claims Representative II, you will have a vital role in investigating, negotiating, and resolving complex Accident Benefits (AB) claims. Your daily interactions with clients and support of client-centric innovative solutions will be impactful to contributing to our client service culture. As the Claims Representative II, you will have the opportunity to grow your expertise in AB claims handling, elevate your analytical mindset, and refine your communication skills.

How you will create impact:

Investigating, interpreting coverage, negotiating and making decisions autonomously, to resolve complex automobile Accident Benefit claims.

Collaborating with clients, physicians, treatment providers, employers and rehabilitation workers in the development, approval, implementation and monitoring of case management plans for clients.

Managing complex files in defense litigation and Alternative Dispute Resolution (ADR).

Coaching, training, and providing technical support to the claims team.

Providing exceptional client service in accordance with our claims service and quality standards, with the view of enabling the organization to be the industry leader in client engagement.

To join our team:

• You have 3+ years of P&C liability claims handling, or related insurance, or legal and/or medically-centric business experience.
• You have a post-secondary degree or diploma.
• You have or are open to working towards the Chartered Insurance Professional (CIP) designation or Medical Rehabilitation designation.
• You have a passion for assessing and solving customer centric problems, and are skilled in priority management.
• Having an understanding of accident benefits insurance coverage is a strong asset.
• You have or will attain provincial adjuster license(s) depending on the province of work.

How you will succeed:

• You influence change and are committed to continuous improvement, in order to exceed client expectations.
• You leverage critical thinking skills to identify problems and proactively propose solutions.
• Your strong communication skills allow you to clearly convey messages.
• You’re an effective team player who shares knowledge to support our peers.

What you need to know:

• You will be subject to a Background check as a condition of employment, in the event you are the successful candidate.

What’s in it for you?

• Training and development opportunities to grow your career.
• Flexible work options and paid time off to support your personal and family needs.
• A holistic approach to your well-being, with physical and mental health programs and a supportive workplace culture.
• Paid volunteer days to give back to your community.
• In addition to our competitive salary and incentive programs, eligible employees also benefit from a comprehensive total rewards package including group retirement savings plans, pension and benefits (e.g., health and wellness, dental, disability and life coverage), mental health support and an employee assistance program.

Salary information

Expected salary range $60,574 to $100,956

The salary amount for the successful candidate is determined by Co-operators in its discretion and will vary depending on several criteria including but not limited to: local market conditions, geography and relevant job-related factors such as knowledge, skills, qualification, experience and education.

Employees may also have the opportunity to participate in incentive programs and earn additional compensation tied to individual and/or business performance, or other business metrics.