Kaufman Claims is seeking an experienced Claims Examiner to manage a portfolio of property and marine claims in a third-party administrator (TPA) environment. The successful candidate will bring hands-on Inland Marine and/or Ocean Marine claims examining or adjusting experience, together with a strong property claims background. You will analyze coverage, develop claim strategy, direct independent adjusters and other experts, maintain accurate reserves, prepare clear reports and recommendations, and provide proactive service to insurer, Lloyd's market and distribution partners.

This is an opportunity to join a growing specialist claims organization backed by the global resources of H.Proactively manage a portfolio of property and Inland/Ocean Marine claims across Canada in accordance with client instructions, service standards, delegated authority and applicable regulatory requirements. Review policy wordings, endorsements, exclusions and claim facts; and prepare timely coverage analyses, status reports, reservation of rights letters and declination or denial correspondence, as appropriate. Appoint, direct and oversee independent adjusters, marine surveyors, engineers, accountants, restoration contractors, legal counsel and other experts. review estimates, inventories, repair documentation, proof of loss forms and expert reports; Communicate promptly and professionally with insurers, Lloyd's brokers and managing agents, underwriters, retail and wholesale brokers, managing general agents, insureds, claimants, adjusters and counsel.

Escalate complex coverage, litigation, reputational or large-loss issues promptly and contribute to file reviews, audits and process improvement.



7+ years of progressively responsible claims examining or adjusting experience. Candidates with 5+ years of highly relevant complex property and marine claims experience may also be considered. ~ Demonstrated hands-on experience with Inland Marine and/or Ocean Marine claims, including cargo, transit or related specialty marine losses. Strong property claims background, ideally including both commercial and residential losses. ~ Advanced ability to read, interpret and apply policy wordings and to communicate defensible coverage positions in writing. ~ Experience directing external adjusters and experts and managing files in an insurer, TPA, independent adjusting or Lloyd's market environment. ~ Sound judgement in investigation planning, reserve setting, negotiation, settlement and escalation. ~ Excellent written and verbal communication skills, including concise insurer reporting and sensitive client and customer communications. ~ CIP, FCIP, CRM or another relevant insurance designation is preferred.

An adjuster license, or eligibility and willingness to obtain and maintain required provincial licensing, is preferred. Commitment to ongoing technical and professional development. Proficiency with Microsoft Word, Excel and Outlook, and the ability to learn carrier,



TPA and claims management systems.

You connect policy language, facts and financial exposure to make clear, defensible recommendations. You build productive relationships across claims, underwriting, operations and external partner teams. You remain organized and composed in a quick-paced environment and are comfortable learning new systems and claim types.

You contribute to fair outcomes, strong client relationships and the long-term success of the organization. WHY KAUFMAN CLAIMS Join a collaborative specialist team where your technical judgement and ownership of files will have a direct impact.

Kaufman

Claims combines the agility of a growing claims organization with access to the expertise, relationships and global reach of H.Kaufman Claims is part of H.Kaufman Group, a privately held global insurance organization. Across a network of more than 60 offices, the Group operates in brokerage, underwriting, risk-bearing and related insurance services and serves partners around the world. Together, our companies are helping shape the future of specialty insurance.

Kaufman

Group is committed to treating all people in a manner that supports dignity, independence, integration and equal opportunity. We welcome applications from all qualified individuals and will accommodate disability-related needs in accordance with applicable provincial human rights legislation throughout all stages of the recruitment and selection process. To request a disability-related accommodation, please inform the Recruiter or contact Human Resources at HRCanada@burns-wilcox.

📌 Medical Claims Processor - Medical Coding (Toronto)
🏢 Burns u0026 Wilcox
📍 Toronto