About This Role
This role involves performing Third Party Administrator (TPA) responsibilities, providing delegated claims administration and management services on behalf of Lloyd’s Syndicates. The Claims Examiner will deliver claims handling and related administrative services in accordance with contractual agreements, service level standards, and client-specific requirements, with a particular focus on Legal Expense Insurance, General Liability and Wrap-Up Liability claims. The incumbent will be responsible for the timely and effective resolution of mid-size to large, complex claims, with an emphasis on achieving cost-effective settlements and timely outcomes on behalf of DWF Claims (Canada) Ltd. and its international and domestic clients.
Responsibilities
- Manage and oversee the investigation of claims, including Legal Expense Insurance, Commercial General Liability (CGL), Wrap-Up Liability, Professional Liability and other liability claims, through the direction of external adjusters and legal counsel
- Analyze and evaluate claim information, including liability, damages, and causation, to determine the extent of exposure
- Assess and interpret policy coverage, liability, and quantum, providing sound and well-reasoned claims analysis
- Effectively implement and manage litigation strategies on assigned files, including oversight of defence counsel and litigation budgets
- Prepare comprehensive, high-quality reports and recommendations for Underwriters and facilitate the accurate administration of claim payments through trust accounts
- Establish and manage claim reserves within delegated authority, recommend reserve adjustments where appropriate, and maintain clear, thorough, and well-documented file notes summarizing claim activity and strategy
- Maintain accurate time recording of claims activities to support reporting, governance, and client billing practices
- Deliver exceptional client service while collaborating effectively with brokers, insureds, clients, third-party claimants, and other stakeholders throughout the claims process
- Provide mentorship and guidance to junior staff, supporting professional development and maintaining claims handling standards
Requirements
- University degree or college diploma
- Minimum of 5 years of liability claims experience
- Demonstrated experience in commercial liability claims examining or adjusting
- Strong oral and written communication skills, with well-developed listening abilities
- Proven collaborative team player, with a preference for working in a team-oriented environment
- Excellent negotiation skills, with sound judgment and diplomacy
- Strong client service orientation, with the ability to respond to and support client and stakeholder needs
- Highly effective time management and organizational skills, with the ability to manage competing priorities