Medical Insurance Examiner jobs

Why join us?:

Our Canadian office is currently recruiting for a Claims Examiner to join our growing team. In this role, the successful candidate will perform Third Party Administrator (TPA) responsibilities, providing delegated claims administration and management services on behalf of Lloyd’s Syndicates. Acting under delegated authority, the Claims Examiner will deliver claims handling and related administrative services in accordance with contractual agreements, service level standards, and client-specific requirements, with a particular focus on Legal Expense Insurance, General Liability and Wrap‑Up Liability claims. The incumbent will be responsible for the timely and effective resolution of mid-size to large, complex claims, with an emphasis on achieving cost-effective settlements and timely outcomes on behalf of DWF Claims (Canada) Ltd. and its international and domestic clients. This position may be performed remotely from anywhere in Canada.

Responsibilities:

• Manage and oversee the investigation of claims, including Legal Expense Insurance, Commercial General Liability (CGL), Wrap‑Up Liability, Professional Liability and other liability claims, through the direction of external adjusters and legal counsel;
• Analyze and evaluate claim information, including liability, damages, and causation, to determine the extent of exposure;
• Assess and interpret policy coverage, liability, and quantum, providing sound and well‑reasoned claims analysis;
• Effectively implement and manage litigation strategies on assigned files, including oversight of defence counsel and litigation budgets;
• Prepare comprehensive, high‑quality reports and recommendations for Underwriters and facilitate the accurate administration of claim payments through trust accounts;
• Establish and manage claim reserves within delegated authority, recommend reserve adjustments where appropriate, and maintain clear, thorough, and well‑documented file notes summarizing claim activity and strategy;
• Maintain accurate time recording of claims activities to support reporting, governance, and client billing practices;
• Deliver exceptional client service while collaborating effectively with brokers, insureds, clients, third‑party claimants, and other stakeholders throughout the claims process; and
• Provide mentorship and guidance to junior staff, supporting professional development and maintaining claims handling standards.

What will help you succeed in this role?:

• University degree or college diploma;
• Minimum of 5 years of liability claims experience;
• Completion of, or progress toward, the Chartered Insurance Professional (CIP) designation is preferred;
• Holds, or is close to obtaining, an Ontario Insurance Adjuster’s Licence, AMF Quebec or an equivalent licence from another Canadian province;
• Demonstrated experience in commercial liability claims examining or adjusting;
• Prior experience as an Independent Adjuster or as a Third Party Administrator (TPA) and working under delegated authority for Lloyd’s Syndicates, is considered a strong asset;
• Ability to work independently and effectively assimilate technical and learning materials from multiple sources;
• Strong oral and written communication skills, with well‑developed listening abilities;
• Proven collaborative team player, with a preference for working in a team‑oriented environment;
• Excellent negotiation skills, with sound judgment and diplomacy;
• Strong client service orientation, with the ability to respond to and support client and stakeholder needs;
• Highly effective time management and organizational skills, with the ability to manage competing priorities; and
• Bilingualism (English/French) and the ability to monitor and handle claims in French would be considered an asset.

What we offer:

The salary range for this position starts at $80,000 per annum and will be determined based on relevant experience and qualifications.

We are committed to ensuring that each member of our team feels valued and duly rewarded during their time at DWF. We are an equal opportunities employer that celebrates diversity and we are committed to creating an inclusive environment for all. We aim to create a positive experience for all candidates and offer any adjustments or additional support needed. If you're excited about the opportunity but your experience doesn’t align perfectly with all the requirements, please apply anyway. You may be the right candidate for the role or others across the wider team.

About us:

DWF is a leading global provider of integrated legal and business services. Our approach delivers efficiency, price certainty and transparency for our clients across the world without compromising on quality or service. Our purpose is to deliver positive outcomes to our colleagues, clients and communities and we foster a culture that places our colleagues at the centre of all that we do.