Dynamic Accident Benefits Claims Adjuster with a proven track record at Definity Insurance, excelling in empathetic client support and critical thinking. Adept at managing complex claims and ensuring compliance with regulations, I leverage strong communication skills to facilitate resolutions while maintaining detailed documentation. Committed to delivering exceptional service and fostering team engagement.
- Manage Accident benefits claims for policyholders in Atlantic Provinces ensuring timely and fair resolution. - Assess medical documentation, treatment plans, and rehab progress to determine coverage and benefits. -Communicate effectively with claimants, medical professionals, and legal reps to facilitate smooth claim handling. - Analyze policy terms, applicable regulations, and case law to make informed claim decisions. -Maintain detailed claim files and provide accurate documentation in compliance with company and regulatory standards. - Support Claimants through their recovery journey with empathy and professionalism while balancing cost management and risk management.
- Handling Auto and Property Claims with low to medium fraud potential. Reviewing policy details, taking detailed statements, identifying additional investigative indicators.
- Supporting clients through the claims process by providing guidance, setting expectations and advising of next steps. - Investigate facts of loss and ask probing questions to confidently make liability decisions.
- Strong interpersonal and negotiation skills and adept in de-escalating situations.
- Capable of managing a large claim workload while working in a demanding environment.
- Manage catastrophic claims on an occurrence basis.
- Identifying subrogation opportunities where applicable. - Automobile total loss handling; adept in presenting total loss valuations.
- Licensed to manage claims in New Brunswick (Level 2 License). - Tort trained to manage Alberta claims and handle subrogation documents as well as third party damages accordingly.
- Liaising with Accident Benefits, Bodily Injury and SIU departments for investigation purposes.
- Team Engagement Ambassador to ensure that team members remain engaged.
- Worked as part of the change ambassador team as well as the vacation support team.
- C11 completed in December 2020, working towards CIP designation
- Working as the Sales Lead, I was in charge of managing the floor. - Greeting every guest that entered our store, making sure employees were up to their tasks, and that guests in our store were satisfied and taken care of.
- From opening and closing the tills, to being a keyholder who would open and close the store, I had a hand in every important responsibility within our retail store.
- Training new hires and an ongoing development of our staff were of the utmost importance in being able to ready ourselves for our guests.
- Working specifically in the Footwear department, I help customers find the product that best suits them.
- Greeting customers and asking questions as to who the product is for, what their intentions are, and helping them choose the best product for them for the best possible price.
- I also handle managerial tasks including but not limited to filling the daily planner to allocate tasks to employees, notify them of new advertisements, setting up department standards, and let them know of any upcoming news.
- Going above and beyond to help customers find what they need, offering them alternatives if we don’t have exactly what they are looking for; always making sure that the customer leaves happy and satisfied.
- setting up the department for new sales, changing ticket prices,
collaborating ideas with upper management for the best direction of the department.
Customer service expertise
Empathy
Accident and incident investigations
Excellent Work Ethic
Verbal and written communication
Flexible and Adaptable
Team player
Insurance policy coverage knowledge
Conflict resolution
High proficiency with Windows-based
programs including spreadsheet and
word-processing applications
Critical thinking
Claims files management processes