Claims Representative

Responsibilities

• Promptly reviews and acts with urgency in establishing initial and subsequent contact with all parties and key stakeholders.
• Provide quality customer service and ensure file quality, timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case.
• Effective and timely communication with insureds, insured general counsel, and make exceptional customer service a top priority.
• Update appropriate parties as needed, providing new facts as they become available, and their impact upon the liability analysis and settlement options.
• Coverage Analyzes and interprets policy language in conjunction with specific loss facts to reach appropriate coverage decisions.
• Proactively communicates with internal and external stakeholders, including insured’s, regarding coverage decisions.
• Maintain discipline in securing and updating key information within the claim handling platform throughout the life of the claim.
• Establishes and maintains appropriate initial and subsequent loss and expense reserves throughout the life of the claim.
• Act with urgency in collaborating with internal stakeholders regarding significant changes within claim reserving.
• Investigate each claim through prompt and strategically appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers, and technical experts to determine the extent of liability, damages, and contribution potential.
• Evaluate all claims for recovery potential; directly handle recovery efforts and/or engage and direct Company resources for recovery efforts.
• Utilize diary management system to ensure that all claims are handled timely.
• Evaluate liability and damages exposure at required time intervals.
• Manage vendors involved with claim files, i.e., Independent Adjusters, Defense Attorneys, and Coverage Counsel.
• Attend and/or present at roundtables/authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expense.
• Share experience and deep knowledge of creative resolution techniques to improve the claim results of others.
• Aid in coaching, training, and mentoring team members.
• Maintain current knowledge of insurance line, court decisions which may impact the claim function, current guidelines in the claim function, and policy changes and modifications.
• Attend professional and/or continuing educational seminars and classes.

Qualifications

• Bachelor’s degree required or prior related insurance experience.
• Insurance related designation (AIC, SCLA and/or CPCU), preferred.
• Have, or ability to obtain adjuster license in required states.
• Claims handling experience, of at least 1 year, in either commercial or personal insurance is required.
• Candidate will possess excellent communication (verbal/written), organizational and interpersonal skills.
• Excellent analytical and problem-solving skills.
• Self-starting, self-motivated and capable of making decisions independently.

Additional Company Details

The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Sponsorship Details

Sponsorship not Offered for this Role.