Intermediate Claims Examiner

Effective April 1, 2024 the salary range for this position is $82,217 to $121,155 per year in compliance with AMAPCEO collective agreement provisions.

The new rates, effective retroactive to April 1, 2024, were recently confirmed and dates for implementation of the new salary rates are still to be determined.

Do you have strong technical knowledge of insurance, claims management and advisory services? In this role, you'll be responsible for accurately assessing and processing insurance claims, investigating discrepancies, and ensuring compliance with organizational policies and industry regulations.

Utilize your analytical skills to make informed decisions and provide excellent customer service to our clients. Consider this exciting opportunity to join the Risk Management and Insurance Services Branch.

We are seeking a committed team player to provide third party liability claims handling expertise to support the government's claims management program.

Please note :

This position is required to report to and work from the physical work location a minimum of three days per week.

OPS Commitment to Diversity, Inclusion, Accessibility, and Anti-Racism :

We are committed to build a workforce that reflects the communities we serve and to promote a diverse, anti-racist, inclusive, accessible, merit-based, respectful and equitable workplace.

We invite all interested individuals to apply and encourage applications from people with disabilities, Indigenous, Black, and racialized individuals, as well as people from a diversity of ethnic and cultural origins, sexual orientations, gender identities and expressions.

Visit the and the pages to learn more about the OPS commitment to advance racial equity, accessibility, diversity, and inclusion in the public service.

We offer employment accommodation across the recruitment process and all aspects of employment consistent with the requirements of Ontario's .

Refer to the "How to apply" section if you require a disability-related accommodation.

What can I expect to do in this role?

You will :

• conduct / lead the negotiation and settlement of moderately complex third party liability claims against the Ontario Government
• provide technical guidance / advice to claims officers on claim handling and conducting file audits
• assess reserves required by the program, assess claim liability against the province and the financial impact of claims
• provide technical advice and guidance to ministry program areas / legal counsel on insurance coverage issues, claims handling standards, protocols and process, mediation / litigation
• provide expert advice and support on the General and Road Liability Protection Program

How do I qualify?

Technical Knowledge and Skills :

• you have knowledge of government insurance policies and experience handling moderately complex third party liability claims ( Municipal, Provincial or Federal)
• you have knowledge of relevant legislation ( Public Transportation and Highway improvement Act, Crown Liability and Proceedings Act, privacy protection legislation) to respond to issues, interpret and apply legislation in the assessment of various claims
• you have knowledge of auditing and risk management assessment practices to lead and report on semi-annual file audits, understand liability issues and assess claims risk
• you have knowledge of the principles, industry standards and best practices of insurance administration, claims investigation and negotiation
• you have knowledge of Ontario civil law procedure and case law and mediation techniques on insurance to review, negotiate and resolve claims and provide expert advice

Communication and Interpersonal Skills :

• you have oral and written communication skills to negotiate settlements, advise on claims management standards, protocols and procedures, to prepare reports and correspondence and respond to a range of queries
• you have consultation and advisory skills to provide expert advice and assistance on claims liability issues, reserving and coverage interpretations and the impact of legislation on claims

Research, Analytical, Math and Computer Skills :

• you are able to investigate / research and assess moderately complex liability claims and calculate and analyze the financial exposure to the province
• you are able to review cases to ensure claims processes, protocols, standards and approaches applied by third party adjusters
• you have the ability to research existing case law and statutes and assess trends of recent court decisions and accurately evaluate the Province's exposure
• you are able to conduct compliance and effectiveness audits of claims handling by third party adjusters in the program
• you have mathematical skills to calculate financial exposure and assess reserves
• you are proficient with computer applications to research and prepare own materials, and related program related software

Negotiation Skills :

you are able to use your strong negotiation and influencing skills to interact with third party adjusters, legal counsel and the public in the investigation and resolution of claims

Additional Information

Address :

1 English Permanent - Full Time, 222 Jarvis St, Toronto, Toronto Region

Compensation Group :

Association of Management, Administrative and Professional Crown Employees of Ontario

Understanding the job ad - definitions

Category :

Consulting and Planning

Posted on :

Wednesday, June 12, 2024

Note :

• T-MG-215246 / 24
How to apply :
• You must .
• You must .
• Your cover letter and resume combined should not exceed five (5) pages. For tips and tools on how to write a concise cover letter and resume, review the .
• Customize your cover letter and resume to the qualifications listed on the job ad. Using concrete examples, you must show how you demonstrated the requirements for this job.

We rely on the information you provide to us.

• Read the to make sure you understand this job.
• OPS employees are required to quote their WIN EMPLOYEE ID number when applying.
• If you require a disability related accommodation in order to participate in the recruitment process, please to provide your contact information.

Recruitment services team will contact you within 48 hours.

All external applicants (including former employees of the Ontario Public Service) applying to a competition in a ministry or Commission public body must disclose (either in the cover letter or resume) previous employment with the Ontario Public Service.

Disclosure must include positions held, dates of employment and any active restrictions as applicable from being rehired by the Ontario Public Service.

Active restrictions can include time and / or ministry-specific restrictions currently in force, and may preclude a former employee from being offered a position with the Ontario Public Service for a specific time period ( one year), or from being offered a position with a specific ministry (either for a pre-determined time period or indefinitely).

The circumstances around an employee's exit will be considered prior to an offer of employment.

Remember : The deadline to apply is Wednesday, June 26, 2024 11 : 59 pm EDT . Late applications will not be accepted.

We thank you for your interest. Only those selected for further screening or an interview will be contacted.

The Ontario Public Service is an inclusive employer.

Accommodation is available under the .