Claims Advisor- Accident Benefits

At Gore Mutual weve always set ourselves apart as a modern mutual that does good. Now were proudly building on that legacy to transform our companyand our industryfor the better.

Effective January 1 2026 Gore has joined Benevathe countrys largest mutual insurance companyas part of its Property & Casualty operations in Ontario and Western Canada. During 2026 Gore will combine its operations with Unica Insurance Benevas Ontario-based subsidiary specializing in niche commercial and personal insurance creating a stronger more diversified mutual insurer with greater scale and long-term stability.

Every decision and investment remains anchored in long-term benefits to customers members and communities. Come join us.

Claims Advisor Accident Benefits- 12 Month Contract

The Accident Benefits (AB) Claims Advisor investigates evaluates and manages low- to moderate-complexity claimsparticularly those under the Minor Injury Guidelineby confirming coverage collecting and reviewing documentation setting reserves negotiating and settling claims coordinating medical management and guiding claimants through the process with clear timely and good-faith communication while also providing front-line support to vendors clinics and insureds and ensuring compliance with FSRA and all applicable legal and regulatory requirements.

What you will do:

• Reviewinginvestigatingand documenting medical reports and claim related information and theappropriate settingof AB Claims reserves.
• Negotiation and Settlement ofclaims oflow tomoderate complexity. Thisoccasionallyincludes preparing and presenting files for authority or strategic approval.
• Supports claims through the timely review and adjudication of Medical Treatment and Assessment Plans within authority
• Direct communications with claimants/ guardians (phone or written) for medically managed claim files
• Communication between internal and external legal counsel case managers and outside vendors
• Invoicing and administrative tasks

What you need to succeed:

• Post secondary Education
• CIP designation is an asset
• 2 years of Claims Handling Experience

• Capableproblem solving and dispute resolution

• Experience working by phone

• Successful hybrid/work from home experience

• Previousexposure to APD handling

• Previousexposure to AB Admin role is ofgreat value

The expected base salary range for this position is $52500 - $86500. Depending on your relevant experience skills qualifications market conditions and business needs base compensation may vary. You have the potential to earn more through Gore Mutuals discretionary bonus program which gives you an opportunity to increase your total compensation provided the business meets its performance targets and you meet your individual goals.

Please note: This range reflects the expected base salary for this role but may not represent the full compensation range for all experience and skill levels. During the recruitment process we will discuss and consider how your unique qualifications align with the broader range for this position.

Gore Mutual is proud to offer a comprehensive total rewards package which includes extended health and dental benefits disability insurance retirement plan matching paid time off recognition and perk programs.

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This posting pertains to an existing vacancy that is actively being filled.

Accessibility for applicants

Gore Mutual Insurance Company is committed to providing accommodations for people with disabilities during all phases of the recruiting process including the application process.

If you require accommodation because of a disability we will work with you to meet your needs.Contact usand a human resources representative will consult with you to determine an appropriate accommodation.

Should you request an accommodation during the interview process please notify your Talent Acquisition Consultant.