Dispute Resolution Specialist, Accident

Company: CGIC

Department:
Claims

Employment Type:

Regular Full Time

Work Model:
Hybrid

Language:
This role operates in English.

Additional Information:
This/these role(s) is/are currently vacant

We are a leading Canadian financial services co-operative committed to being a catalyst for a sustainable and resilient society and our team is essential to deliver on this strategy. That’s why we prioritize our people, to ensure we provide a strong culture and development opportunities which enables our team to thrive and to live our purpose. The best part is that you will work with people that care passionately about you, our clients, and our communities.

Our Claims team is aspiring to create peace of mind for our clients and our communities. Our national team of knowledgeable and trusted professionals serve our clients with compassion. We are passionate about continuous improvement and operate with high-integrity, motivated by our desire to do the right thing for our clients.

The Dispute Resolution Specialist, Accident Benefits represents Co-operators and CUMIS for disputes at the License Appeal Tribunal (LAT) in Ontario. The License Appeal Tribunal (LAT) through the Ministry of Attorney General office, is the only avenue that clients in Ontario have to dispute a decision that an Insurer has made. Dispute Resolution Specialists work independently within their authority to negotiate and settle claim disputes, coach claims representatives in the dispute response process.

• Where appropriate, collaborate with staff on assignment of defense legal counsel and act as a liaison with external counsel.
• Prepare claim files for case conference including identifying issues, exposures and strategies for resolution at mediation and create the Case Conference Summary.
• Identify and assess any risk to our trust and reputation and address immediately with claims staff. Review, analyze and quantify financial risk to company.
• Present persuasive arguments supporting rationale on the type of Hearing required should the case conference not be successful in resolving the dispute and work with Lat adjudicator and plaintiff counsel to arrange hearing dates.
• Identify and present arguments regarding preliminary issues and/or motions that need to be addressed prior to any hearing on substantive matters.
• Expertly negotiate when appropriate and persuasively facilitate a compromise between client expectations and company philosophy to successfully resolve the dispute or have it withdrawn.
• Coach, advise, and assist in the development of claims representatives in making sound decisions regarding complex claims, litigation management, policy interpretation, policy violations, quantum, assessment, negotiation and settlement of claims.
• Compile data regarding our LAT disputes for such as types of disputes, counsel involved, results, decisions rendered, costs. Analyze and report on trends. in LAT disputes and file handling.

• You have an innovative mindset to improve operational efficiencies and ability to influence change, with a primary focus on client needs.
• You use critical thinking skills to recognize assumptions, evaluate arguments, draw conclusions and proactively propose solutions.
• You have strong communication skills to clearly convey messages and explore diverse points of view.
• You build trusting relationships and provide guidance to support the development of colleagues.

• 5 years successful claims handling experience related to the discipline with progressively developing complexity, including experience with legal and complex claims in Accident Benefits in Ontario.
• Extensive experience in negotiation and a track record of success in claims resolution.
• FCIP designation and/or Dispute Resolution designation and pursuing further development.
• Expert knowledge of legislation, regulations, and legal system, including dispute resolution practices and applicable case law.
• University/College Degree.

• You will travel occasionally.
• You will be subject to a Background check as a condition of employment, in the event you are the successful candidate.

• T…