Auto Physical Damage Senior Claim Representative

About the company

MSIG USA is the US-based subsidiary of MS&AD Insurance Group Holdings, Inc., one of the world’s top P&C carriers and a global Class 15 insurer, with A+ ratings and a reach that spans 40+ countries and regions. Leveraging our 350-year heritage, MSIG USA brings the financial strength, expertise, and global footprint to offer commercial insurance solutions that address your business’s unique risks.

Responsibilities

• Handles commercial auto physical damage claims within assigned authority and in accordance with MSMM Claims Handling Guidelines.
• Resolves routine repairable losses directly and owns outcomes for claims routed to appraisal, estimating, and salvage partners, including coverage, liability, cost, and cycle time.
• Delivers prompt, accurate, and fair results for insureds, claimants, and brokers while controlling loss costs and complying with applicable fair claims practices requirements.
• INTAKE, COVERAGE, AND LIABILITY: Review new auto physical damage assignments at first notice of loss; verify the policy, vehicle schedule, applicable coverages, and endorsements, including comprehensive, collision, specified perils, and hired and non-owned autos; identify coverage questions and potential bodily injury exposures.
• Make timely, well-documented liability determinations using police reports, statements, photographs, dashcam and telematics data, and scene information while applying the negligence and comparative fault rules of the governing jurisdiction.
• Triage each claim to the appropriate handling channel under the department’s physical damage routing protocol, including adjuster-authorized estimates, virtual appraisal, field or heavy-vehicle appraisal, and total loss; re-route claims as the damage picture develops.
• DAMAGE EVALUATION AND REPAIR MANAGEMENT: Follow established protocols to evaluate physical damage, including total loss evaluation and processing, and deliver timely decisions and payments to support efficient cycle times.
• Review vendor appraisals, supplements, and repair invoices for accuracy, including labor rates and operations, consistent with policy terms and applicable state law.
• Actively manage rental and loss-of-use, towing, and storage exposures; move vehicles promptly to limit storage accrual and resolve disputed charges.
• TOTAL LOSS AND SALVAGE: Identify probable total losses early and follow established total loss and vendor management protocols.
• Evaluate diminished value claims when presented, based on policy terms and applicable jurisdictional law.
• RECOVERY AND FRAUD IDENTIFICATION: Identify subrogation opportunities at intake; preserve evidence; place responsible parties and carriers on notice; and pursue recovery directly or through inter-company arbitration, including recovery of the insured’s deductible.
• Recognize fraud indicators; report to ISO ClaimSearch and NICB as required; and make timely referrals to SIU in accordance with company procedures.
• CLAIM ADMINISTRATION AND COMPLIANCE: Set and adjust reserves promptly and accurately within assigned authority; escalate files that exceed authority or present coverage, litigation, or severity concerns.
• Maintain complete and current electronic claim files and diaries, documenting investigation, evaluation, and settlement rationale clearly.
• Comply with applicable unfair claims settlement practices laws and regulations; maintain required adjuster licenses and complete continuing education requirements.
• Issue accurate payments, including electronic and digital payments, to the appropriate insureds, claimants, repair facilities, and lienholders.
• CUSTOMER AND STAKEHOLDER SERVICE: Communicate proactively with insureds, claimants, brokers, and fleet managers through phone, email, text, and digital portals; explain coverage, valuation, and repair decisions in clear, plain language.
• Recognize dedicated accounts and follow account-specific special handling instructions