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. 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

Manage a caseload of Accident Benefit (AB) claims from initial notice to resolution, ensuring timely and appropriate claims handling

Assess and investigate claims, including coverage verification, file documentation, and coordinating independent assessments and medical reports

Apply the SABS and associated legislation, guidelines, and case law consistently and effectively

Communicate empathetically and professionally with claimants, healthcare providers, legal counsel, and third-party vendors

Negotiate and settle claims where appropriate, while ensuring fair outcomes for members and compliance with regulatory frameworks

Maintain accurate records and detailed claim notes in the claims management system

Participate in regular file reviews and contribute to continuous improvement initiatives in claims practices

Stay current with legislative and regulatory changes affecting AB claims in Ontario

Desired Competencies

Strong knowledge of SABS and Ontario insurance legislation

Excellent organizational and time management skills, with the ability to prioritize and multitask

Sound judgement, analytical thinking, and problem-solving skills

Exceptional communication and interpersonal abilities, with a member-first mindset

Demonstrated ability to handle sensitive situations with empathy and professionalism

Proficiency in claims management software and Microsoft Office Suite

Ability to work both independently and collaboratively within a team environment

Continuous learner with a commitment to professional development

 Qualifications

University Degree or post-secondary education related to insurance

Completion of Chartered Insurance Professional (CIP) designation or enrollment in the program

Minimum of 3 years of experience handling Accident Benefit claims

Familiarity with HCAI, medical assessments, and case law application is required

Experience in a mutual insurance company environment is a strong asset

Completion of a Drivers Abstract, and Criminal Records Check will be required

This role will require travel. A vehicle, valid Driver’s License and insurance are required.

What we offer

We are an equal opportunity employer offering:

A flexible hybrid work environment

A rewarding career and comprehensive compensation & benefits package

Training, education, and career advancement opportunities

A work environment that is fun and friendly and supports a healthy work-life balance

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.