Claim Examiner
Toronto, Ontario
BRIEF DESCRIPTION:
Reporting to the Manager of Claims, this full-time role is responsible for the adjudication of accident & health claims and related customer service.
RESPONSIBILITIES INCLUDE:
Manage a portfolio of Medical, Disability and Critical Illness claims including oversight of reporting, notification, evaluation, case reserving, settlement and file closure.
Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution
Settlement of claims within designated authority.
Regular communication with the claimant and the client.
Manage relationships with, and ensure appropriate handling by, external TPAs, adjusters and counsel.
Identify process improvements and recommend changes to policies or procedures to improve quality of service and competitiveness.
THE SUCCESSFUL CANDIDATE:
5+ years of Accident & Health claims experience. Some commercial P&C experience an asset.
A college diploma or a university degree is an asset.
Experience working with Lloyd’s coverholders an asset.
Have a strong ability to multitask and thrive in a fast-paced environment.
Are a skilled communicator.
Bilingual (English/French) preferred.
LOCATION:
Downtown Toronto, hybrid office/remote
About Sutton:
Sutton Special Risk is a Managing General Underwriter, Lloyd's Coverholder, and Lloyd's Broker, formed in 1978, providing worldwide A&H and P&C insurance and reinsurance solutions to North American brokers and intermediaries. Insurance clients include employer and affinity groups, expats, executives, professional athletes and the film and entertainment industry. We are recognized as one of the insurance industry’s Top Employers in Canada by Benefits and Pensions Monitor, and we’ve been named one of Canada’s Top Small and Medium Employers in 2024. We scored an above-industry average rating for excelling at recognizing employees and their accomplishments.
Only those who satisfy the Successful Candidate criteria will be contacted for an interview.