Position Overview

The core responsibilities of the Claims Adjuster is to ensure the company meets its mission statement of Protecting your future as if its our own. You will accomplish this by helping the policyholder navigate the claims process through your investigation and evaluation of the loss to final settlement. By demonstrating empathy and professionalism, you will continue to build on the excellent reputation HTM has for serving our policyholders.

Position Responsibilities

Process Liability/Property/Auto Claims (85%)

• Customer Service: In all instances, maintain a focus on service to the customer and strive for compliance with HTM published Service Standards.
• Communication: ensure prompt initial contact with insureds and claimants and maintain open and clear communication throughout the claim process. Explain fully the policy response, the claims process, and the responsibilities of the insured in the submission and adjustment of the loss/damage. Document critical conversations with confirming letter.
• General: Adjust claims for Property, Liability & Auto (Physical damage only). You would also assist with claims of HTMs board members as per our company policy.
• New claim assignment: Establish appropriate initial case reserves with consideration to the relevant minimum reserves in effect.
• Procedure: Institute and follow the appropriate claims handling protocol for the type of claim involved: Residential, Farm, or Commercial Property; Residential, Farm or Commercial Liability, Auto Physical Damage
• Coverage: Assess coverage under the policy in force and immediately notify the insured of any potential obstacle to indemnity, documenting the notification with a signed Non Waiver or Reservation of Rights letter. Where appropriate, secure a legal opinion to clarify. Arrange, as soon as possible for containment, documentation and an accurate and fair assessment of damage to insured property. Provide the insured with all necessary forms and direction for claim submission. Verify scope and value of submitted claims.
• Investigation: Conduct a thorough Investigation of all aspects of the occurrence, identifying all involved parties, documenting findings and securing evidence for future reference.
• Experts: Where appropriate, retain and direct experts to assist in the determination of origin and cause or responsibility for the occurrence

• Coverage/Liability/Subrogation: Re-assess coverage as required to establish company position. Assess the insureds legal liability in third party claims and identify, and evaluate subrogation opportunities. Any claim denial, in whole or in part, must be supported by written correspondence with a full explanation of the reasons for refusal along with the appropriate blank Proof of Loss form as per statutory requirement.
• Adjustment: Apply policy terms and prevailing law to damage assessments and evaluated claims to calculate appropriate entitlement/compensation.
• Service Providers: Assign and manage all outside vendors involved in the claim.
• Reserves: Regularly review reserve adequacy including upon receipt of new information pertaining to damages. Adjust case reserves as appropriate to support predictable outcome of all claim costs/expenses.
• Litigation Management: Where required, assign appropriate defence counsel and manage the course and expense of the litigation process, including focus on settlement strategy. Participate in the selection of expert witnesses and settlement meetings, mediations, arbitrations, pre-trials and trials.
• Settlement/Payments: Negotiate settlement and execute payment in exchange for appropriate closing documents; Proof of Loss, Release, Dismissal, Discontinuance, and process payments.
• Reports/Documentation: Document all activity/contacts in file notes or in the Claim Remarks section of your data file. Document rationale for all decisions/adjustments. Complete interim and summary reports to file on all large loss claims. Maintain compliance with all external reporting requirements.
• File Management/Closure: Ensure claim process is continually moving forward in a timely fashion to fair, accurate, and economic resolution and closure.

Additional Responsibilities (15%)

• Attend and participate in Claims department meetings
• Support HTMs Strategic Plan and Department Goals as required
• Participate in education and training as required and remain current with changes in legislation, regulation, case law, and form changes as pertains to the role of an adjuster.
• Maintain strong positive relationships with all external customers
• Attend industry related events and retain membership in external organizations as required.
• Support co-workers as required

This job may require additional responsibilities and duties as assigned by HTM.

Education and Experience

Must Have

Asset

Education Level

College or University or

CIP

FCIP

Major Subjects/Specialties

Business, Law

Type of Experience

Multi-line claims adjusting.

Prior employment with a Mutual

Knowledge, Skills & Attributes

Knowledge required to perform duties:

General knowledge of P & C Insurance

Understanding of Mutual Insurance Industry

Insurance and contract law

Policy forms & Coverage

Computer skills

Fraud awareness and detection

Skills and abilities required to perform duties:

Attention to detail and high level of accuracy

Superior communication skills (written and verbal)

Time management and organizational skills

Conflict resolution and negotiation skills

Analytical skills; ability to complete thorough assessments

Relationship building, team building, & Customer service skills

Equipment required to perform duties:
Standard office equipment

Access to a vehicle and valid drivers license

Key Relationships

Reports to:

Claims Supervisor

Works with:

Claims Department

Underwriting Department

Accounting

Inspections Department

Line manages:

Nil

External

Policyholders/Insureds

Brokers

Contractors

Appraisers

Experts

Other Insurance Agencies

Independent Adjusters

Public Authorities

Farm Mutual Re

OMIA

Surveillance Firms