Sr Representative, Claims- Accident Benefits

Job Description

Reporting to the Team Leader, Accident Benefit Claims, you are accountable for investigating, evaluating and settling Accident Benefit claims

What can you expect in this role?

• Report to the Team Leader, Accident Benefit Claims, while investigating, evaluating and settling accident benefit claims in accordance with the Insurance Act
• Securing details of claims by corresponding with claimants and / or representatives
• Assessing coverage eligibility and reviewing and applying interpretations of policy wordings in the resolution of coverage issues
• Applying applicable Priority Rules chart to each claim file
• Processing income replacement, non-earner, and attendant care claims
• Reserving files appropriately after assessing claim
• Maintaining detailed file records on an electronic claims system
• Processing payments after confirming benefits, eligibility and reserves
• Coordinating the most effective course of action for claims
• Confirming collateral benefits
• Responding to claimant correspondence and accident benefit forms in accordance with the applicable legislation
• Reviewing and approving, when appropriate, treatment plans for claimant rehabilitation
• Arranging insurer examinations to determine benefits eligibility
• Preparing referral packages and obtaining the necessary medical information for insurer examinations
• Responding to assessment recommendations
• Other duties as assigned

What do you bring to the role?

Salary range is $55,800 - $102,800

About Us

Interested in this role, but don’t meet every requirement?  We encourage you to apply! We know from experience that a candidate doesn’t need 100% of the qualifications listed to bring incredible value to our team. We’re actively seeking diverse backgrounds and perspectives to help us make insurance better. At Definity, inclusion, diversity, and equity aren’t just “nice to have” — they’re essential to our success.

What’s in it for you?

Actual salary for the role may vary depending on work location of the successful candidate and other factors including but not limited to, skills, education, experience, working conditions and the local labour market.  In addition to base pay, eligible employees may participate in various incentive plans which are paid out at the discretion of the company and subject to individual and company performance.

Go ahead and expect a lot — you deserve it.

Our inclusive work environment welcomes diversity and supports accessibility. If you require accommodation at any time during the recruitment process, please let us know by contacting .

Background checks

This role requires successful clearance of background checks (including criminal checks and leadership references).