POSITION SUMMARY
Kaufman Claims is seeking an experienced Claims Examiner to manage a portfolio of property and marine claims in a third-party administrator (TPA) environment. The successful candidate will bring hands-on Inland Marine and/or Ocean Marine claims examining or adjusting experience, together with a strong property claims background.
This role owns files from assignment through resolution. You will analyze coverage, develop claim strategy, direct independent adjusters and other experts, maintain accurate reserves, prepare clear reports and recommendations, and provide proactive service to insurer, Lloyd's market and distribution partners. This is an opportunity to join a growing specialist claims organization backed by the global resources of H.W. Kaufman Group.
KEY RESPONSIBILITIES
- Proactively manage a portfolio of property and Inland/Ocean Marine claims across Canada in accordance with client instructions, service standards, delegated authority and applicable regulatory requirements.
- Review policy wordings, endorsements, exclusions and claim facts; identify coverage issues; and prepare timely coverage analyses, status reports, reservation of rights letters and declination or denial correspondence, as appropriate.
- Establish an investigation and resolution strategy for each file, including clear action plans, diary dates and next steps.
- Appoint, direct and oversee independent adjusters, marine surveyors, engineers, accountants, restoration contractors, legal counsel and other experts.
- Evaluate cause, damage, liability and quantum; review estimates, inventories, repair documentation, proof of loss forms and expert reports; and challenge unsupported findings or costs.
- Set, review and maintain appropriate loss and expense reserves. Prepare reserve and settlement recommendations for matters that exceed delegated authority.
- Communicate promptly and professionally with insurers, Lloyd's brokers and managing agents, underwriters, retail and wholesale brokers, managing general agents, insureds, claimants, adjusters and counsel.
- Negotiate fair, well-supported settlements within authority and obtain client approval when required.
- Identify and pursue salvage, subrogation and other recovery opportunities, where appropriate.
- Maintain complete, accurate and audit-ready file documentation while meeting reporting, diary and service-level requirements.
- Escalate complex coverage, litigation, reputational or large-loss issues promptly and contribute to file reviews, audits and process improvement.
REQUIRED EXPERIENCE AND SKILLS
- 7+ years of progressively responsible claims examining or adjusting experience. Candidates with 5+ years of highly relevant complex property and marine claims experience may also be considered.
- Demonstrated hands-on experience with Inland Marine and/or Ocean Marine claims, including cargo, transit or related specialty marine losses. Experience across both is strongly preferred.
- Strong property claims background, ideally including both commercial and residential losses.
- Advanced ability to read, interpret and apply policy wordings and to communicate defensible coverage positions in writing.
- Experience directing external adjusters and experts and managing files in an insurer, TPA, independent adjusting or Lloyd's market environment.
- Sound judgement in investigation planning, reserve setting, negotiation, settlement and escalation.
- Excellent written and verbal communication skills, including concise insurer reporting and sensitive client and customer communications.
- Ability to manage a full caseload, competing priorities and strict deadlines through a disciplined diary system.
- Strong attention to detail, organization, analytical thinking and follow-through.
EDUCATION, CREDENTIALS AND TECHNOLOGY
- Post-secondary education or an equivalent combination of education and directly relevant experience.
- CIP, FCIP, CRM or another relevant insurance designation is preferred.
- An adjuster license, or eligibility and willingness to obtain and maintain required provincial licensing, is preferred.
- Commitment to ongoing technical and professional development.
- Proficiency with Microsoft Word, Excel and Outlook, and the ability to learn carrier, TPA and claims management systems.
HOW YOU WORK
- You take ownership. You move files forward, anticipate obstacles and follow through on commitments.
- You are analytical and practical. You connect policy language, facts and financial exposure to make clear, defensible recommendations.
- You are client-focused. You communicate early, clearly and professionally, especially when issues are complex or sensitive.
- You are collaborative. You build productive relationships across claims, underwriting, operations and external partner teams.
- You are adaptable. You remain organized and composed in a fast-paced environment and are comfortable learning new systems and claim types.
- You act with integrity. You contribute to fair outcomes, strong client relationships and the long-term success of the organization.
WHY KAUFMAN CLAIMS
Join a collaborative specialist team where your technical judgement and ownership of files will have a direct impact. Kaufman Claims combines the agility of a growing claims organization with access to the expertise, relationships and global reach of H.W. Kaufman Group.
ABOUT OUR COMPANY
Kaufman Claims is part of H.W. Kaufman Group, a privately held global insurance organization. Across a network of more than 60 offices, the Group operates in brokerage, underwriting, risk-bearing and related insurance services and serves partners around the world. Together, our companies are helping shape the future of specialty insurance.
OUR COMMITMENT
H.W. Kaufman Group is committed to treating all people in a manner that supports dignity, independence, integration and equal opportunity. We welcome applications from all qualified individuals and will accommodate disability-related needs in accordance with applicable provincial human rights legislation throughout all stages of the recruitment and selection process.
To request a disability-related accommodation, please inform the Recruiter or contact Human Resources at [email protected] or 416-774-2477. Information related to accommodation will be handled confidentially.
We thank all applicants for their interest. Only candidates selected for an interview will be contacted.
