Accident Benefit Adjuster

Accident Benefit Adjuster 
 
MutualONE Insurance Company Where a shared culture fuels our passion and a deep commitment to our members drives everything we do. Where innovation, exceptional service, and trusted protection come together to create powerful insurance solutions. Where every team member plays a part in building something extraordinary.
 Together, we are ONE — stronger, bolder, and ready for the future!
 
About the Role
Are you looking for your next opportunity in the insurance industry? MutualONE is seeking an experienced Accident Benefit Adjuster to join our claims team in a fully remote role (within Ontario). Reporting to the Manager of Claims Services, you will manage a portfolio of Accident Benefits claims in accordance with the Statutory Accident Benefits Schedule (SABS) and other legislative requirements. This role is ideal for someone who is empathetic, detail-oriented, and committed to helping injured persons navigate the claims process fairly and efficiently.
 
Key Responsibilities
<ul>
<li>Manage a caseload of Accident Benefit (AB) claims from initial notice to resolution, ensuring timely and appropriate claims handling</li>
<li>Assess and investigate claims, including coverage verification, file documentation, and coordinating independent assessments and medical reports</li>
<li>Apply the SABS and associated legislation, guidelines, and case law consistently and effectively</li>
<li>Communicate empathetically and professionally with claimants, healthcare providers, legal counsel, and third-party vendors</li>
<li>Negotiate and settle claims where appropriate, while ensuring fair outcomes for members and compliance with regulatory frameworks</li>
<li>Maintain accurate records and detailed claim notes in the claims management system</li>
<li>Participate in regular file reviews and contribute to continuous improvement initiatives in claims practices</li>
<li>Stay current with legislative and regulatory changes affecting AB claims in Ontario</li>
</ul>
 
Desired Competencies
<ul>
<li>Strong knowledge of SABS and Ontario insurance legislation</li>
<li>Excellent organizational and time management skills, with the ability to prioritize and multitask</li>
<li>Sound judgement, analytical thinking, and problem-solving skills</li>
<li>Exceptional communication and interpersonal abilities, with a member-first mindset</li>
<li>Demonstrated ability to handle sensitive situations with empathy and professionalism</li>
<li>Proficiency in claims management software and Microsoft Office Suite</li>
<li>Ability to work both independently and collaboratively within a team environment</li>
<li>Continuous learner with a commitment to professional development</li>
</ul>
 
 Qualifications
<ul>
<li>University Degree or post-secondary education related to insurance</li>
<li>Completion of Chartered Insurance Professional (CIP) designation or enrollment in the program</li>
<li>Minimum of 3 years of experience handling Accident Benefit claims</li>
<li>Familiarity with HCAI, medical assessments, and case law application is required</li>
<li>Experience in a mutual insurance company environment is a strong asset</li>
<li>Criminal Records Check will be required</li>
</ul>
 
This role requires the individual to reside in Ontario.
 
What we offer
We are an equal opportunity employer offering:
<ul>
<li>A rewarding career and comprehensive compensation & benefits package</li>
<li>Training, education, and career advancement opportunities</li>
<li>A work environment that is fun and friendly and supports a healthy work-life balance</li>
</ul>
 
At MutualONE, your efforts will always make a difference!
 
Interested? We want to hear from you!
 
We thank all applicants for their interest, however, only those considered for an interview will be contacted.
 
No phone calls or agencies please.
 
ACCESSIBILITY STATEMENT (AODA IN ONTARIO)
MutualONE is committed to providing a barrier-free work environment in concert with the provincial guidelines for accessibility (Accessibility for Ontarians with Disabilities Act and the Ontario Human Rights Code, Ontario Only).
As such, MutualONE will make accommodations available to applicants with disabilities upon request during the recruitment process.
 
HUMAN RIGHTS STATEMENT
MutualONE strives to ensure that its employment practices are free from direct and indirect discrimination and is committed to upholding the human rights of those participating in the hiring process. In pursuit of this commitment, MutualONE will not condone or tolerate any acts of discrimination or harassment under any of the grounds protected under human rights legislation. This commitment extends to the hiring process and throughout the course of employment.

Accident Benefit Adjuster - Remote

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