PIP - Consultant Casualty Claims

About the role

The Consultant Casualty Claims is responsible for managing no-fault claims that typically involve minimal to moderate injury and disability severity. Duties include verifying coverage, evaluating medical bills and applicable no-fault benefits for payment, and maintaining clear communication with claimants, third parties and providers.

Responsibilities

• Manage a caseload of moderately complex casualty claims from intake through resolution.
• Conduct thorough investigations, assess liability, and evaluate damages using established procedures.
• Collaborate with underwriting, legal, and internal/external stakeholders as needed to ensure comprehensive claim evaluation.
• Identify and refer potentially suspicious claims to the Special Investigations Unit.
• Apply comparative negligence laws and state-specific regulations to claim assessments.
• Set reserves, authorize payments, and demonstrate financial acumen within scope of authority.
• Utilize technology and data tools to enhance claims processing efficiency and accuracy.
• Communicate directly with claimants, legal representatives, and third parties to negotiate fair resolutions.
• Maintain detailed and compliant documentation of claim activities and communications.
• Participate in team collaboration, problem-solving discussions, and cross-functional coordination.
• Support subrogation efforts and risk transfer opportunities to benefit insureds and business partners.
• Handle sensitive communications professionally and translate complex information for diverse audiences.
• Mentor entry-level claim handlers and share best practices learned through training and experience.
• Attend ongoing training and education to maintain licensing and stay current on industry standards.
• Independently manage indemnity, medical, and basic arbitration or mediation components of claims with supervisory support.

Requirements

Associate degree required; bachelor's degree preferred or combination of education and experience. Typically has 1-4 years of relevant claims handling experience. Conduct independent analysis of contractual indemnification. Independently execute indemnity, medical, litigation/resolution management. Proficient with basic computer navigation; ability to use basic software systems/applications (Suite of MS Office Products) and use of internet. Learn and handle negotiations independently within authority, understand common tactics for moderately complex claim resolution. Use judgement and effectively utilize the most suitable communication channel while displaying empathy towards all stakeholders. Knowledge of various types of insurance products and processes. Conduct thorough investigations; identify key issues and gather evidence. Provide effective empathetic customer service; handle routine inquiries and issues.

Qualifications

Core Capabilities: Analytical Reasoning, Customer Centricity, Digital Fluency, Persuasion and Influence, Professional Insurance Acumen, Planning and Execution.

Skills

Must possess or obtain and maintain appropriate state adjuster licenses.

Benefits

We offer comprehensive benefits to help you be healthy, build financial security, and balance work and home life. At The Hanover, you’ll enjoy what you do and have the support you need to succeed. Benefits include: Medical, dental, vision, life, and disability insurance; 401K with a company match; tuition reimbursement; PTO; company paid holidays; flexible work arrangements; cultural awareness day in support of IDEOn-site medical/wellness center (Worcester only); Click here for the full list of Benefits.

Career Development

The Hanover values diversity in the workplace and among our customers. The company provides equal opportunity for employment and promotion to all qualified employees and applicants on the basis of experience, training, education, and ability to do the available work without regard to race, religion, color, age, sex/gender, sexual orientation, national origin, gender identity, disability, marital status, veteran status, genetic information or any other status protected by law. Furthermore, The Hanover Insurance Group is committed to providing an equal opportunity workplace that is free of discrimination and harassment based on national origin, race, color, religion, gender, ancestry, age, sexual orientation, gender identity, disability, marital status, veteran status, genetic information or any other status protected by law.” As an equal opportunity employer, Hanover does not discriminate against qualified individuals with disabilities. Individuals with disabilities who wish to request a reasonable accommodation to participate in the job application or interview process, or to perform essential job functions, should contact us at: HRServices@hanover.com and include the link of the job posting in which you are interested.