JO-ELLEN KAMSTRA
Port Perry,Canada
Summary
Results-driven Casualty Claims Design Manager with 14 years of experience in Accident Benefits as an Adjuster, Alternative Dispute Resolution Adjuster, Manager, and Design Manager. With over 20 years in the insurance industry, possesses expertise in Ontario, Alberta, and the Maritimes Casualty Claims. Passionate about working towards company advancement, demonstrates a proven history of collaborating with key stakeholders and working independently to achieve goals. Provides technical casualty claims expertise and leadership to ensure efficient and effective work processes, cost-effective above-quality service, risk minimization, vendor relationship management, and overall continuous improvement.
Overview
12
12
years of professional experience
Work History
Casualty Claim Design Manager
ALLSTATE INSURANCE COMPANY
04.2023 - Current
- Ensure the delivery of national results to positively impact Allstate Canada Group financial performance within appropriate Claim performance metrics within Key Performance area of cost containment & customer satisfaction
- Identifying the key operational & financial metrics, while proactively monitoring results for adversity in collaboration with partners from Corporate Risk, Data & Analytics
- Brings forward identified both adverse & positive trends along with potential solutions that the Casualty Claims Design Manager will implement initiatives with support of the National Delivery Directors & their teams to execute
- Works to improve line of sight between operational results/activities and reserving activities in claims through the analysis of reports & quality assurance work
- Ensure proper execution and regional regulatory/legislative compliance of claim procedures and practices and make process recommendations to ensure full compliance to requirements
- Drive positive customer satisfaction by delivering the value proposition defined by the brands for the regions through the day-to-day guidance on claims handling and recommending the sourcing and utilization of appropriate service providers
- Recommend and implement action plans and processes to achieve severity and ALAE plans
Claims Manager, Senior Casualty Claims
ALLSTATE INSURANCE COMPANY
03.2022 - 04.2023
- Manage team's activities as required, by organizing, planning, and controlling optimal use of human, financial, data and material resources, in line with corporate strategies, while promoting teamwork and identifying training needs
- Provide regular status reports on the progress of all activities
- Maintain effective communication channels with claims departments (Casualty/Bodily Injury, Accident Benefits, Auto and Property)
- Empower employees to take responsibility for their jobs and goals
- Delegate responsibility and expect accountability and regular feedback
- Foster a spirit of teamwork that allows for disagreement over ideas, conflict and expeditious conflict resolution, and the appreciation of diversity as well as cohesiveness, support, and working effectively together to enable each employee to succeed
- Consciously create a workplace culture that is consistent with the overall organization's and that emphasizes the identified mission, vision, guiding principles, and values of the organization
- Lead employees using a performance management and development process that provides an overall context and framework to encourage employee contribution and includes goal setting, feedback, and performance development planning
- Lead employees to meet the organization's expectations for productivity, quality, continuous improvement, and goal accomplishment
- Provide effective performance feedback through employee recognition, rewards, and disciplinary action
- Maintain employee work schedules including assignments, job rotation, training, vacations, and paid time off, cover for absenteeism, and overtime scheduling
- Maintain transparent communication
- Plan and allocate resources to effectively staff and accomplish the work to meet departmental productivity and quality goals
- Plan, evaluate, and improve the efficiency of business processes and procedures to enhance speed, quality, efficiency, and output
- Make business decisions that are financially responsible, accountable, justifiable, and defensible in accordance with organization policies and procedures
- Communicate regularly with other managers, the director, and other designated contacts within the organization
Claims Manager – Minor Injury Guideline Unit
ALLSTATE INSURANCE COMPANY
11.2018 - 04.2022
- Manage team's activities as required, by organizing, planning, and controlling optimal use of human, financial and material resources, in line with corporate strategies, while promoting teamwork and identifying training needs
- Motivate and coach team by setting and monitoring goals and objectives, evaluating performance, and holding regular huddle meetings to keep staff informed of changes and new projects
- Provide regular status reports on the progress of all activities
- Mentor and provide guidance to team members
- Maintain effective communication chaManage team's activities as required, by organizing, planning, and controlling optimal use of human, financial, data and material resources, in line with corporate strategies, while promoting teamwork and identifying training needs
- Provide regular status reports on the progress of all activities
- Maintain effective communication channels with claims departments (Casualty/Bodily Injury, Accident Benefits, Auto and Property)
- Empower employees to take responsibility for their jobs and goals
- Delegate responsibility and expect accountability and regular feedback
- Foster a spirit of teamwork that allows for disagreement over ideas, conflict and expeditious conflict resolution, and the appreciation of diversity as well as cohesiveness, support, and working effectively together to enable each employee to succeed
- Consciously create a workplace culture that is consistent with the overall organization's and that emphasizes the identified mission, vision, guiding principles, and values of the organization
- Lead employees using a performance management and development process that provides an overall context and framework to encourage employee contribution and includes goal setting, feedback, and performance development planning
- Lead employees to meet the organization's expectations for productivity, quality, continuous improvement, and goal accomplishment
- Provide effective performance feedback through employee recognition, rewards, and disciplinary action
- Maintain employee work schedules including assignments, job rotation, training, vacations, and paid time off, cover for absenteeism, and overtime scheduling
- Maintain transparent communication
- Plan and allocate resources to effectively staff and accomplish the work to meet departmental productivity and quality goals
- Plan, evaluate, and improve the efficiency of business processes and procedures to enhance speed, quality, efficiency, and output
- Make business decisions that are financially responsible, accountable, justifiable, and defensible in accordance with organization policies and procedures
- Communicate regularly with other managers, the director, and other designated contacts within the organizationnnels with claims departments (Casualty/Bodily Injury, Accident Benefits, Auto and Property)
- Coach, mentor, and develop staff, including overseeing new employee onboarding and providing career development planning and opportunities
- Empower employees to take responsibility for their jobs and goals
- Delegate responsibility and expect accountability and regular feedback
- Foster a spirit of teamwork that allows for disagreement over ideas, conflict and expeditious conflict resolution, and the appreciation of diversity as well as cohesiveness, support, and working effectively together to enable each employee to succeed
- Consciously create a workplace culture that is consistent with the overall organization's and that emphasizes the identified mission, vision, guiding principles, and values of the organization
- Lead employees using a performance management and development process that provides an overall context and framework to encourage employee contribution and includes goal setting, feedback, and performance development planning
- Lead employees to meet the organization's expectations for productivity, quality, continuous improvement, and goal accomplishment
- Provide effective performance feedback through employee recognition, rewards, and disciplinary action
- Maintain employee work schedules including assignments, job rotation, training, vacations, and paid time off, cover for absenteeism, and overtime scheduling
- Maintain transparent communication
- Appropriately communicate organization information through huddles, one-on-one meetings, and appropriate email, Teams (Instant Messaging), and regular interpersonal communication
- Plan and allocate resources to effectively staff and accomplish the work to meet departmental productivity and quality goals
- Plan, evaluate, and improve the efficiency of business processes and procedures to enhance speed, quality, efficiency, and output
- Make business decisions that are financially responsible, accountable, justifiable, and defensible in accordance with organization policies and procedures
- Review performance data reports and spreadsheets, to monitor and measure departmental productivity, goal achievement, and overall effectiveness
- Communicate regularly with other managers, the director, and other designated contacts within the organization
- Perform other duties and responsibilities, as assigned
Claims Adjuster, Alternative Dispute Resolution Adjuster
ALLSTATE INSURANCE COMPANY
04.2016 - 11.2018
- Critical analysis of large loss Accident Benefit claims by demonstrating analytical and problem-solving skills to assess situations and determine the most effective use with each case as a means of resolving disputes and possible file settlements
- Demonstrates the ability to consider information, facilitate discussion, clarify and summarize issues and weight pros and cons of each option
- Demonstrates the ability to identify underlying issues and determine when /if to approach parties on unresolved conflicts and/or settlement of the claim
- Demonstrates the ability to concisely deliver oral decisions and direction to claim advisors and Legal Counsel
- Demonstrates administration and time management skills to organize and prioritize a high volume and time sensitive workload
- Superior handling of LAT, Mediations (In-person and telephone), Global Mediations and Arbitrations, Pre-Arbitrations
- Maintaining detailed file records on an electronic claims system
- Ensuring proper reserves are noted on claim files
- Excellent investigation skills which include investigation into WSIB, Collateral Benefits, Priority and Loss Transfer
- Highly motivated and able to work well independently and as part of a team
Claims Adjuster, Accident Benefits (Serious Injury Unit)
ALLSTATE INSURANCE COMPANY
03.2014 - 04.2016
- Securing details of claims by corresponding with claimants and/or representatives in person and via telephone
- Assessing coverage eligibility and reviewing and applying interpretations of policy wording in the resolution of coverage issues
- Reserving files appropriately after assessing a claim
- Maintaining detailed file records on an electronic claims system
- Processing payments after confirming benefits, eligibility, and reserves
- Coordinating the most effective course of action for claims
- Processing and responding to correspondence within the applicable timelines and in accordance with the applicable legislation
- Reviewing and approving, when appropriate, treatment and/or assessment plans for claimant rehabilitation
- Request Insurer Examinations when appropriate
- Strong negotiation and settlement skills
- Excellent knowledge of the Statutory Accident Benefits Schedule
- Senior & CAT experience in Medical including, Rehabilitation, Housekeeping and Home Maintenance, Caregiver, Attendant Care, Lost Educational Expense, Non-earner and Income Replacement Benefits
- Investigate and evaluate claims (Fractures/chronic pain/brain injuries, CAT etc.), collect data and determine loss exposure, all within approved authority levels
- Excellent investigation skills which include investigation into WSIB, Collateral Benefits, Priority and Loss Transfer
Claims Adjuster, Accident Benefits (Level 3)
UNIFUND ASSURANCE
08.2012 - 03.2014
- Securing details of claims by corresponding with claimants and/or representatives in person and via telephone
- Assessing coverage eligibility and reviewing and applying interpretations of policy wording in the resolution of coverage issues
- Reserving files appropriately after assessing a claim
- Maintaining detailed file records on an electronic claims system
- Processing payments after confirming benefits, eligibility and reserves
- Coordinating the most effective course of action for claims
- Processing and responding to correspondence within the applicable timelines and in accordance with the applicable legislation
- Reviewing and approving, when appropriate, treatment and/or assessment plans for claimant rehabilitation
- Request Insurer Examinations when appropriate
- Strong negotiation and settlement skills
- Excellent knowledge of the Statutory Accident Benefits Schedule
- Senior experience in Medical, Rehabilitation, Housekeeping and Home Maintenance, Caregiver, Attendant Care, Lost Educational Expense, Non-earner and Income Replacement Benefits
- Investigate and evaluate claims (Fractures/chronic pain/brain injuries/CAT etc.), collect data and determine loss exposure, all within approved authority levels
- Excellent investigation skills which include investigation into WSIB, Collateral Benefits, Priority and Loss Transfer
Education
CIP
Insurance Institute of Canada
Vocational Rehabilitation - Part 1
Seneca
Understanding Serious Injury course - certificate
The Insurance Institute
AB Medical Management Skill Builder Series -
InHealth
Interpreting Medical Reports -
The Dominion Academy
Graphic Design -
Seneca
Skills
- Strategic Thinking
- Technical knowledge
- Policy Interpretation
- Risk Assessment
- Coaching abilities
- Innovation Fostering
- Risk Management
- Empathy Development
- Regulatory Compliance
- Legal proceedings knowledge
- Claims trend analysis
- Project Leadership
Educationandprofessionaldevelopment
Principles & Practice of Insurance, Automobile Insurance Part 1, Insurance on Property Part 1, Bodily Injury Claims, Vocational Rehabilitation – Part 1 – Seneca, Understanding Serious Injury course - The Insurance Institute certificate, AB Medical Management Skill Builder Series – InHealth, Interpreting Medical Reports – The Dominion Academy, Graphic Design (1 year) – Seneca, High School Diploma – Port Perry High School, Awesome Customer Service with Dave Vanderpan, Empathy Seminar with Dave Vanderpan, Computer and Business Skills Training – Windows 2000, Excel, Power Point, Mediation Seminar with Miller Thomson Lawyers, Structured Settlement Seminar, Leading with Analytics
Languages
English
Full Professional
Timeline
Casualty Claim Design Manager
ALLSTATE INSURANCE COMPANY
04.2023 - Current
Claims Manager, Senior Casualty Claims
ALLSTATE INSURANCE COMPANY
03.2022 - 04.2023
Claims Manager – Minor Injury Guideline Unit
ALLSTATE INSURANCE COMPANY
11.2018 - 04.2022
Claims Adjuster, Alternative Dispute Resolution Adjuster
ALLSTATE INSURANCE COMPANY
04.2016 - 11.2018
Claims Adjuster, Accident Benefits (Serious Injury Unit)
ALLSTATE INSURANCE COMPANY
03.2014 - 04.2016
Claims Adjuster, Accident Benefits (Level 3)
UNIFUND ASSURANCE
08.2012 - 03.2014
Vocational Rehabilitation - Part 1
Seneca
Understanding Serious Injury course - certificate
The Insurance Institute
AB Medical Management Skill Builder Series -
InHealth
Interpreting Medical Reports -
The Dominion Academy
CIP
Insurance Institute of Canada
Graphic Design -
Seneca
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