Insurance Training

C. Roderick Thorne

* ***** *****,

Scarborough, ON., M1K 3P9

Tel: 416-***-****

Email: ***.******@*******.***

Skills: Analytical skills; oral and written communication; working knowledge of the Statutory Accident Benefits Schedule, experience in its interpretation and application; negotiation; evaluating claim files and initiating proposals to settle claims; organization handling and adjusting over 200 claims files; working in a team to formulate best practices in file handling; resolution of disputes with claimants, legal reps and clinics regarding benefit claims; mediation by telephone and face-to-face to settle disputes and files with claimants and their legal reps.

Work History

Accident Benefits Adjuster

Granite Claims Solutions: May 2011 – April 2012

Responsibilities: As an independent adjuster managing a portfolio of 80 files of minor to complex injuries from inception to closure in compliance with the best practices of the accounts: investigating accident circumstances to determine coverage for claims; Approving, calculating and authorizing payment of weekly and monthly specified benefits claims; evaluating requests for treatment and assessments, approving appropriate plans; scheduling Sec 44 Insurer Examinations to obtain diagnoses of injuries and disabilities, determine need for requested treatment, assessments, and entitlement to specified benefits; verbal and written communication with insureds, claimants, legal representatives, treating practitioners, Insurer Examiners; Understanding, interpreting and applying the Statutory Accident Benefits Schedule to maintain compliance; investigating and pursuing recoveries from other insurers through available Extended Health Benefits coverage, loss transfers and insurer priority. Reviewing, analysing the progress of the claim to set appropriate reserves according to company philosophy. Preparing monthly reports for the accounts.

Accident Benefits Adjuster

Unifund Claims Inc: August 2005 – January 31, 2011

Responsibilities: Adjusting an open pending ranging from 105 to 300 claims from inception to natural closure, or by negotiated settlement, mediation or arbitration. Attending face-to-face mediations, arbitrations and pre-hearings. Investigating claims coverage and approving, calculating and paying specified benefits; reviewing treatment and assessment plans, approving appropriate treatment and assessments; Scheduling Insurer Examinations to review need for denied treatment, and continued specified benefits; verbal and written communications with insureds, claimants, lawyers, paralegals, treating practitioners, Insurer Examiners, company lawyers; Understanding, interpreting and applying the Statutory Accident Benefits Schedule through legislated

Page 2/

changes to maintain compliance; investigating for, and pursuing recoveries including Extended Health Benefits, loss transfers and priority; analyzing the progress of the file for reserving purposes.

Aviva Canada Inc.

Accident Benefits Adjuster on contract August 2004 - May 2005

Responsibilities: Member of a five-person team in the Injury Claims Unit adjusting WAD I, II & III claims from inception to closure, negotiation and settlement, or transfer to a senior adjuster when appropriate. Particular responsibility for approving, calculating and paying weekly benefits; and in consultation with another team member determining appropriate treatment, reviewing, approving or denying treatment plans; reviewing and approving or rejecting requests for specialist assessments; scheduling Insurer Examinations to determine need for treatment, assessments, continued need for weekly benefits; communicating with insureds, claimants, lawyers, paralegals, treating practitioners, Insurer Examiners, In-house and external lawyers; Understanding, interpreting and applying the Statutory Accident Benefits Schedule to maintain compliance; investigating the legitimacy of claims.

Cameron & Associates September 2003 – March 2004

Accident Benefits Adjuster on contract

Approving, calculating weekly benefits; reviewing treatment and assessment plans, approving appropriate treatment and assessments; scheduling Insurer Examinations to review need for treatment, assessments, continued need for weekly benefits; communicating with insureds, claimants, legal representatives, treating practitioners, Insurer Examiners; Understanding, interpreting and applying the Statutory Accident Benefits Schedule to maintain compliance.

Education:

CIP: Chartered Insurance Professional designation completed January 2011.

Completed: Statutory Accident Benefits training courses and occasional updates. Seminars by Company Legal counsel on legislation updates.

Seminars by Insurer Examiners on disabilities, examinations and determining appropriate medical examiners.

Seminars on surveillance and insurance fraud.

Reserve review training courses.

Completed: Certificate in Business Systems and Administration – Ryerson University 1992.

Temporary Independent Adjuster license

References available upon request.

Contact this candidate