Senior Claims Examiner

Burns & Wilcox Canada; Toronto; On-site; CAD 90,000 - 130,000; Full time

Job summary

Kaufman Claims is seeking a highly experienced Senior Claims Examiner to lead the management of complex property and liability claims within a third-party administrator (TPA) environment. You will independently manage high-exposure losses from first notice through final resolution, providing coverage analysis and strategic direction.

Ideal candidates have 5–7 years of advanced claims experience, strong negotiation skills, and the ability to mentor junior staff while ensuring audit-ready

Qualifications

• 5-7 years of progressively responsible claims experience with complex property and marine claims.
• Strong property claims expertise, including large-loss and complex claims management.
• Advanced knowledge of policy interpretation and contract wording.
• Experience in insurer/TPA/independent adjusting or Lloyd's market environments.
• Ability to manage high-exposure claims with minimal supervision.
• Strong reserve management, negotiation, litigation management, and settlement skills.
• Excellent written and verbal communication; ability to explain complex issues clearly.
• Experience mentoring junior team members.

Responsibilities

• Independently manage a portfolio of complex, high-severity claims across Canada.
• Analyze policy wordings and determine coverage with defensible positions.
• Prepare coverage analyses, letters, and client reports.
• Develop and execute investigation and resolution strategies for complex claims.
• Evaluate liability, causation, damages, and loss quantification.
• Maintain reserves and develop settlement strategies within authority.
• Provide coaching and mentoring to Claims Examiners.

Skills

Senior experience

Property claims

Coverage analysis

High-exposure claims

Negotiation skills

Reserving & settlement

Mentoring

Communication

Organizational skills

Education

Post-secondary education in business/insurance/law

Provincial Adjuster License

Ongoing professional development

Tools

Microsoft Office

Claims management systems

Job description

Kaufman Claims is seeking a highly experienced Senior Claims Examiner to lead the management of complex property and liability claims within a third-party administrator (TPA) environment. The successful candidate will possess extensive technical expertise in property and liability claims, exceptional coverage analysis capabilities, and a proven ability to independently manage high-exposure and complex losses from first notice through final resolution.

KEY RESPONSIBILITIES

Claims Management & Technical Leadership

• Independently manage a portfolio of complex, high-severity, and specialty property and lability claims across Canada.
• Analyze policy wordings, endorsements, exclusions, and claim circumstances to determine coverage and develop defensible coverage positions.
• Prepare detailed coverage analyses, reservation of rights letters, declination letters, settlement recommendations, and client reports.
• Establish and execute effective claim investigation and resolution strategies for complex claims involving significant financial, legal, or reputational exposure.
• Evaluate liability, causation, damages, business interruption exposures, and loss quantification.
• Maintain accurate indemnity and expense reserves, ensuring reserve adequacy throughout the claim lifecycle.
• Develop settlement strategies and negotiate claim resolutions within delegated authority while obtaining client approval when required.
• Provide coaching, technical guidance, and mentoring to Claims Examiners and junior claims staff.
• Act as a subject matter expert for complex property and marine coverage issues.
• Assist management with file reviews, quality assurance initiatives, training programs, and best practice development.
• Share technical expertise and industry knowledge to strengthen overall team capability.

Operational Excellence

• Maintain complete, accurate, and audit-ready documentation.
• Ensure compliance with client service instructions, regulatory requirements, internal procedures, and delegated authorities.
• Identify trends, emerging risks, and process improvement opportunities.
• Support claims audits, reporting initiatives, and operational projects.
• Escalate significant coverage, litigation, regulatory, and large-loss matters appropriately.

REQUIRED EXPERIENCE & SKILLS

• At least 5-7 years of progressively responsible claims examining or adjusting experience, including substantial responsibility for complex property and marine claims.
• Strong commercial property claims expertise, including large-loss and complex claims management.
• Advanced knowledge of policy interpretation, coverage analysis, and insurance contract wording.
• Demonstrated experience operating within insurer, TPA, independent adjusting, or Lloyd's market environments.
• Proven ability to manage high-exposure claims with minimal supervision.
• Strong reserve management, negotiation, litigation management, and settlement skills.
• Exceptional analytical, problem-solving, decision-making, and risk assessment abilities.
• Excellent written and verbal communication skills with the ability to communicate complex technical issues clearly and effectively.
• Experience mentoring and supporting junior team members is strongly preferred.
• Strong organizational skills with the ability to manage multiple competing priorities and deadlines.

EDUCATION, CREDENTIALS & TECHNOLOGY

• Post-secondary education in business, insurance, risk management, law, or a related field, or an equivalent combination of education and experience.
• Provincial Adjuster License or the ability to obtain and maintain required licensing.
• Commitment to ongoing professional development and industry education.
• Advanced proficiency in Microsoft Office applications and claims management systems.

WHY KAUFMAN CLAIMS

Join a collaborative and growing specialty claims organization where your expertise directly contributes to client success. As a Senior Claims Examiner, you will have the opportunity to manage challenging and complex claims while helping shape team performance, technical excellence, and client service standards across the organization