The SCMIP became operational on June 1, 2025. The Pool was established to provide a sustainable, municipally governed insurance pool model designed to reduce long-term premium costs, increase claims handling consistency, improve risk management practices, strengthen intermunicipal collaboration, and take greater control of the claims and insurance programs. The Pool consists of 18 members including the County of Simcoe, and 17 area municipalities. The SCMIP purchases insurance on a group basis for these municipalities and manages all their claims and offers risk management services to all members.
Under the direction of the SCMIP Supervisor, Risk and Claims, this role involves examining, investigating, negotiating, mitigating, and settling claims for SCMIP Members. Responsibilities include examining claims where Third Party Adjusters (TPAs) perform full adjusting functions, developing procedures for efficient claim handling and gathering data for record-keeping and loss forecasting, estimating the financial value of claims and maintaining accurate records, tracking documentation and payments in a centralized claims handling software (ClearRisk), and adjusting insurance claim files from start to finish, including site inspections, information collection, and recommending payment or denial based on legislation. The role places a strong emphasis on managing physical damage auto claims, and prior experience in this area would be considered a valuable asset.
1. Examine, validate information and provide direction on claims adjusted by TPA’s and when required, attend loss locations, meetings or collect required information to adjudicate such claims.
2. Investigate, negotiate, resolve or deny claims made against the SCMIP members for bodily injury, property losses, general liability, vehicle and transit losses within authorized limits as delegated by the Risk Manager.
3. Assign field investigation to Third Party Adjusters (TPA’s) to attend accidents or loss scenes, photograph, and take statements from claimants and witnesses as required.
4. Review TPA task assigned statements from claimants and witnesses to assist in determining liability and negotiating the compensation or resolve of losses.
5. Retain the services of outside experts such as appraisers, engineers, medical specialists and rehabilitation firms. Review their reports and take action as necessary.
6. Prepare reports, system reports and records as directed and update claims management data within ClearRisk. Comply with the established procedures for documenting the claim file and financial systems.
7. Provide informational updates and receive direction on significant claims and risk management issues from the Risk Manager and insurer.
8. Provide a review of loss data and risk management services recommendations to the Risk Manager. Work with the Supervisor of Risk and Claims to facilitate required training for frequently occurring claims received by the SCMIP members to establish risk mitigation for future claims.
9. Complete all required forms in accordance with Legislated Regulations, internal policies and procedures, as well as Standard Operating Procedures.
10. Maintain a good working knowledge of case law including statutes such as The Insurance Act of Ontario, The Highway Traffic Act, The Occupier’s Liability Act, The Negligence Act, The Municipal Act, Minimum Maintenance Standards for Municipal Highways, and any other statutes relevant to the types of claims handled.
11. Participate in professional associations to maintain and exchange beneficial information.
12. Conduct investigations or assignments outside of regular work hours as required.
13. Perform all computer and system related activities consistent with the functional requirements of the job.
14. Other duties as assigned, including deployment in emergency situations.
15. Comply with provincial and County occupational health and safety legislation, regulations, policies and procedures.
16. Maintain confidentiality in accordance with the Municipal Freedom of Information and Protection of Privacy Act.
Has knowledge of and demonstrated ability in our corporate competencies:
- Acts with the Customer in Mind
- Continuously Seeks to Improve Work Processes
- Minimum of a two (2) year college diploma in Business Administration. This job may be considered for education equivalency in accordance County Policy.
- Certified Insurance Professional Designation (CIP) with the Insurance Institute of Canada.
- Certified Risk Manager Designation – CRM (will be an asset).
- Computer skills in Excel, Word, or equivalent.
- Asset to know and understand claims handling software ClearRisk.
- Ability to communicate well, both written and orally.
- Must be able to maintain a high level of confidentiality.
- Must be able to handle a busy workload.
- Willing and able to provide a Police clearance check.
- Criminal records check that is less than 6 months old at time of hire.
- Valid G class drivers license and access to reliable vehicle.
- At least 5 (five) years’ experience in the insurance industry involving the adjusting and processing of claims; significant exposure related to physical damage auto claims, property damage claims and bodily injury claims; the understanding of medical terminology and the interpretation of medical reports; the exposure to setting of reserves; exposure to underwriting and loss analysis.
- Mental and visual effort required when performing analysis and reporting.
- Regular office environment.
- Some travel within Simcoe County required.
- Ability to work remotely if required.
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