SENIOR CLAIMS EXAMINER

Kaufman Claims is seeking a highly experienced Senior Claims Examiner to lead the management of complex property and liability claims within a third-party administrator (TPA) environment. The successful candidate will possess extensive technical expertise in property and liability claims, exceptional coverage analysis capabilities, and a proven ability to independently manage high-exposure and complex losses from first notice through final resolution.

KEY RESPONSIBILITIES

Claims Management & Technical Leadership

- Independently manage a portfolio of complex, high-severity, and specialty property and lability claims across Canada.
- Analyze policy wordings, endorsements, exclusions, and claim circumstances to determine coverage and develop defensible coverage positions.
- Prepare detailed coverage analyses, reservation of rights letters, declination letters, settlement recommendations, and client reports.
- Establish and execute effective claim investigation and resolution strategies for complex claims involving significant financial, legal, or reputational exposure.
- Evaluate liability, causation, damages, business interruption exposures, and loss quantification.
- Maintain accurate indemnity and expense reserves, ensuring reserve adequacy throughout the claim lifecycle.
- Develop settlement strategies and negotiate claim resolutions within delegated authority while obtaining client approval when required.

Leadership & Mentorship

- Provide coaching, technical guidance, and mentoring to Claims Examiners and junior claims staff.
- Act as a subject matter expert for complex property and marine coverage issues.
- Assist management with file reviews, quality assurance initiatives, training programs, and best practice development.
- Share technical expertise and industry knowledge to strengthen overall team capability.

Operational Excellence

- Maintain complete, accurate, and audit-ready documentation.
- Ensure compliance with client service instructions, regulatory requirements, internal procedures, and delegated authorities.




- Identify trends, emerging risks, and process improvement opportunities.
- Support claims audits, reporting initiatives, and operational projects.
- Escalate significant coverage, litigation, regulatory, and large-loss matters appropriately.

REQUIRED EXPERIENCE & SKILLS

- At least 5-7 years of progressively responsible claims examining or adjusting experience, including substantial responsibility for complex property and marine claims.
- Robust commercial property claims expertise, including large-loss and complex claims management.
- Advanced knowledge of policy interpretation, coverage analysis, and insurance contract wording.
- Demonstrated experience operating within insurer, TPA, independent adjusting, or Lloyd's market environments.
- Proven ability to manage high-exposure claims with minimal supervision.
- Strong reserve management, negotiation, litigation management, and settlement skills.
- Exceptional analytical, problem-solving, decision-making, and risk assessment abilities.
- Excellent written and verbal communication skills with the ability to communicate complex technical issues clearly and effectively.
- Experience mentoring and supporting junior team members is strongly preferred.
- Strong organizational skills with the ability to manage multiple competing priorities and deadlines.

EDUCATION, CREDENTIALS & TECHNOLOGY

- Post-secondary education in business, insurance, risk management, law, or a related field, or an equivalent combination of education and experience.
- CIP designation required.
- Provincial Adjuster License or the ability to obtain and maintain required licensing.
- Commitment to ongoing professional development and industry education.
- Advanced proficiency in Microsoft Office applications and claims management systems.

WHY KAUFMAN CLAIMS

Join a collaborative and growing specialty claims organization where your expertise directly contributes to client success. As a Senior Claims Examiner, you will have the opportunity to manage challenging and complex claims while helping shape team performance, technical excellence, and client service standards across the organization

📌 Senior Claims Examiner (Toronto)
🏢 Burns u0026 Wilcox Canada
📍 Toronto