Senior Claims Specialist, Personal Lines Accident Benefits

Zurich Insurance Company Ltd.•Waterloo, ON

14d•Hybrid

About The Position

Zurich Canada is seeking a Senior Claims Specialist, Personal Lines Accident Benefits, for their Waterloo office. This role involves handling single and multi-party commercial and personal lines claims with low to high exposure and complexity within specific authority limits. The specialist will ensure claims are managed efficiently and effectively, providing a customer-centric service. This is an opportunity to enhance knowledge and experience in a supportive environment. Zurich Canada utilizes AI-enabled tools for initial application review, but all hiring decisions are made by qualified professionals. The position follows a hybrid work model, requiring three days per week in-person presence.

Requirements

Bachelor’s Degree and 3 or more years of experience in the Claims or Insurance area OR Zurich Certified Insurance Apprentice, including an Associate Degree and 3 or more years of experience in Claims or Insurance area OR Completion of Zurich Claims Training Program and 3 or more years of experience in the Claims or Insurance area OR High School Diploma or Equivalent and 5 or more years of experience in the Claims or Insurance area
Knowledge of insurance regulations, markets, and products
Microsoft Office experience

Nice To Haves

Minimum 3 years of experience handling personal lines accident benefit claims
Effective verbal and written communication skills
Strong analytical, critical thinking, and problem solving skills
Solid time management, prioritization, and multi-tasking skills
Experience collaborating in a team environment and building cross functional working relationships
Adept in identifying and explaining complex financial and/or actuarial concepts
Ability to determine the scope and exposure for moderately complex claims
Demonstrates understanding of the reserving process for indemnity and expense in analyzing the potential exposure of moderately complex claims
Ability to develop and execute a negotiation strategy and plan for resolution
Ability to identify subtleties in customer/client and/or business partner interactions
Ability to present information necessary to propose a claim resolution to stakeholders

Responsibilities

Handle personal lines accident benefit claims in good faith and in accordance with legislative requirements and best practices
Handle moderate to complex loss transfer claims
Determine priority for commercial and personal lines accident benefit claims
Document claims files by accurately capturing and updating claims data/information in compliance with best practices for single and multi-party personal line claims of moderate to high exposure and complexity, including LAT disputes
Exercise judgment to determine liability by gathering and analyzing relevant facts, utilizing applicable law, and establishing basic principles of negligence
Perform policy verification and coverage determination by analyzing applicable coverage for claims and determining whether the loss falls within accident benefits coverage
Develop case strategies and evaluations to ensure timely resolution of claims, escalating issues as appropriate
Establish timely reserves and perform ongoing reviews throughout the claims cycle within authority limits by estimating and validating the value of claims
Assess damages by calculating applicable damages or range of damages allowed by law
Negotiate settlements by establishing appropriate negotiation strategies and utilizing available tools and resources within authority limits
Maintain quality standards by following best practices