WTP – Claims Examiner

WTP – Claims Examiner

Job Information
Author pmnationtalk
Date June 20, 2022
Deadline Open
Type Full Time
Company Zurich Canada
Location Toronto, ON
Category Miscellaneous
Client Zurich Canada
Contact Information
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WTP – Claims Examiner

90407

Job Summary

World Travel Protection provides global travellers with specialist emergency assistance services when something goes wrong in their travels. We operate 24 hours a day, seven days a week from our 4 operation centres in Australia, Canada, China and Malaysia, responding to the cries for help we receive from travellers across the globe.

Owned by Zurich, but with separately managed business entities, we can truly offer you a world of possibilities within assistance and insurance. Get ready to do your best work…and then some.

Investigate, evaluate and conclude low exposure, low complexity personal or commercial line claims by following established protocols to ensure that claims are handled in the most effective, efficient way while delivering a customer-centric claims service.

Job Qualifications

Required:
• Bachelors Degree and No prior experience required in the Customer Service area
OR
• High School Diploma or Equivalent and No prior experience required in the Customer Service area
OR
• Zurich Certified Insurance Apprentice including an Associate Degree and No prior experience required in the Customer Service area
AND
• Microsoft Office experience

Preferred:
• Geographic flexibility
• Analytical skills
• Prioritization and multi-tasking skills
• Strong verbal and written communication skills
• Experience working in a team environment and collaborating across work groups

Job Accountabilities – Key Accountabilities

• Capture and update claims data/information in compliance with best practices for low complexity, low exposure personal or commercial line claims.
• Determine liability by gathering relevant facts, utilizing applicable law and establishing basic principles of negligence.
• Confirm policy existence by identifying coverage on low complexity claims.
• Work to have a timely resolution to claims by developing case strategy, developing a case evaluation, escalating issues as appropriate and providing status updates to ensure customer satisfaction.
• Establish timely reserves within authority limit by estimating value of claims.
• Assess damages by calculating applicable damages or range of damages allowed by law.
• Ensure customer service by proactively communicating information, responding to inquiries and following customer protocols.
• Manage expenses by working within vendor approved networks and managing scope of work assigned to outside contractors. Depart from approved vendors with manager approval, where in the best interests of the insured.
• Ensure legal compliance by following state and federal laws and regulations and internal control requirements.
• Refer claim to subrogation and fraud teams by identifying potential subrogation and fraud.
• Protect Zurich’s reputation by keeping claims information confidential.
• Maintain professional and technical knowledge by participating in educational opportunities, staying current with industry trends, establishing personal networks and participating in professional societies.
• Contribute to the team effort by accomplishing related results and participating on projects as needed.
• Follow established claims handling procedures for low complexity, low exposure personal or commercial line claims to ensure consistency and quality in claims services.
• Collect data and document in established system to facilitate the accurate assessment and value of claims.
• Input relevant data into established systems accurately so that analysis can be undertaken.
• Identify and resolve problems by referring to policies, procedures, and standards to ensure consistency and quality of solutions.
• Assess and appoint claims vendors within agreed authority limits aligned to the organization´s Claims Vendor Management strategy.
• Determine when to solicit input from more senior colleagues or managers for more complex issues, to ensure quality and promote continuous learning.
• Provide feedback on business processes and systems to identify opportunities for improvements.

Job Functions

• May negotiate settlement of claim by establishing appropriate negotiation strategy and utilizing available tools and resources within authority limits.
• May participate in customer marketing efforts.
• May contribute to profitable growth by providing risk insight, information and trends to Business Unit or customer as needed.

Business Accountabilities

• Develop a practical understanding of how processes and systems in own area of work relate to the management of risk and compliance.
• Adhere to local regulatory and governance requirements throughout the life of a claim to ensure decisions are made using the right standards.
• Acquire and organize the relevant evidence and information to accurately assess the value of a claim.
• Provide feedback and recommendations for improvement of processes and systems.
• Respond to and resolve enquiries and problems, judging when to pass complex queries on to or involve others, to provide an effective service and clear advice to colleagues and customers.
• Respond to queries from customers and/or colleagues to ensure customers receive appropriate advice.

A future with Zurich

Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 148 years of experience managing risk and supporting resilience. We are a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. Today, we serve more than 25 industries, from agriculture to technology and insure 90% of the Fortune 500®. Our growth strategy is not limited to our business. As an employer, Zurich strives to provide ongoing career development opportunities and foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our people, our customers and the communities we serve.

As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, diversity and inclusion bring us closer to our common goal: exceeding our customers’ expectations. Zurich is committed to providing a diverse, inclusive and barrier-free environment resulting in an accessible organization for employees, customers, and other parties who interact with, or on behalf of, Zurich. We strive to achieve a workplace free of discrimination of all forms, including discrimination on the basis of physical or mental disability, or medical condition. If you are interested in a job opportunity, please advise if you require an accommodation, so we can work with you to provide a more accessible process.

Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich Canadian Holdings Limited. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission.

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