Doris Joseph Email & Phone Number

 Securing details of claims by corresponding with claimants and/or representatives in person and via telephone.  Assessing coverage eligibility, reviewing and applying interpretations of policy wordings in the resolution of coverage issues.  Applying applicable Priority Rules chart to each claim file.  Processing election of benefit claims.  Reserving files appropriately after assessing claim.  Maintaining detailed file records on an electronic claims system, Guidewire… Show more  Securing details of claims by corresponding with claimants and/or representatives in person and via telephone.  Assessing coverage eligibility, reviewing and applying interpretations of policy wordings in the resolution of coverage issues.  Applying applicable Priority Rules chart to each claim file.  Processing election of benefit claims.  Reserving files appropriately after assessing claim.  Maintaining detailed file records on an electronic claims system, Guidewire  Processes and documents claims payments promptly according to company guidelines, obtaining authority from appropriate Claims Specialist or Unit Manager, to maximize loss cost management.  Coordinating the most effective course of action for claims.  Analyze information gathered on coverage, liability and quantum to verify authenticity and appropriateness of claims submitted Show less

Mississauga, Ontario

 Investigated, evaluated and settled Ontario Accident Benefit claims, collected data and determined loss exposure within approved authority level. Processed and forwarded necessary explanations and documents in compliance with SABS. Provided comprehensive application and stoppage responses for the specified benefits. Confirmed effective financial management of claims and prepared income calculation for employed claimants. Established case reserves and issued claim payments on a… Show more  Investigated, evaluated and settled Ontario Accident Benefit claims, collected data and determined loss exposure within approved authority level. Processed and forwarded necessary explanations and documents in compliance with SABS. Provided comprehensive application and stoppage responses for the specified benefits. Confirmed effective financial management of claims and prepared income calculation for employed claimants. Established case reserves and issued claim payments on a timely basis as per MIG/Non-MIG claim. Liaised with stakeholders in the claims process to ensure clients' rehabilitation needs were met; included health practitioner, treatment provider, employer, and lawyer. Partnered in basic mediation process and seamlessly resolved issues which included denied treatment plans. Show less

Mississauga, Ontario

 Achieved and consistently maintained 90% service level target on the client queue and file disposition rate of 90% on a monthly basis. Initiated salvage and subrogation procedures on assigned claims.  Arranged car rentals for the clients with preferred rental agencies. Trained through job shadowing and supervised new team members/internal staff to observe and minimize individual risk.

Mississauga, Ontario

 Managed appraisal process as per report and worked with appraisers to determine and communicate damages; utilized Auto source valuation in resolving of total loss claims explaining valuation report to insured. Requested “Bill of Sale” if the policy had a 43 Endorsement coverage by removing depreciation deduction.  Completed claims payment authorization process including lien searches and VIN history; reviewed and processed total loss settlement payments according to company… Show more  Managed appraisal process as per report and worked with appraisers to determine and communicate damages; utilized Auto source valuation in resolving of total loss claims explaining valuation report to insured. Requested “Bill of Sale” if the policy had a 43 Endorsement coverage by removing depreciation deduction.  Completed claims payment authorization process including lien searches and VIN history; reviewed and processed total loss settlement payments according to company guidelines. Included co-pay scenarios with insured and lien holders or leasing companies. Negotiated and settled claims within authority level of up to $75K and requested necessary authorization. Show less

Mississauga, Ontario

 Assigned claims to internal Auto and Property adjusters in Ontario and independent Adjusters (Crawford). Completed efficient and accurate set-up of incoming claims, including data entry, preparing file jackets and processing cheque payments. Collaborated with brokers/underwriters ensuring correct information was provided for processing new claims. Conducted claims count at the end of the day and input information into spreadsheets (Excel).