Under minimal supervision, investigate and resolve first and third party material damage, WC, PIP and BI claims which may involve coverage, liability, damage and legal issues.
Effort may concentrate around large exposure, Commercial Auto, Homeowner liability, and/or Commercial Property claims among other market/line combinations.
Provide guidance and direction to legal counsel during the litigation process in order to ensure favorable resolution.
Act as a mentor to new employees to facilitate the on-boarding process.
Settlement authority up to $45,000.00 and expenseauthority up to $7,500.00
Timely completion of all case activities, maximizing customer service and minimizing net loss payout.
Contacts all insureds, claimants and witnesses that may have information relating to the loss, either in person, by telephone or in writing. This may include visiting the accident location to examine, photograph and diagram physical facts and conduct neighborhood canvasses.
Inputs and retrieves information using the automated claims system, requests checks, form letters and other correspondence through the automated claim system.
Evaluates case facts determining coverage, liability and reserves, and reports on settlement; maintains a reminder system.
Evaluates case facts confirming coverage and appropriate damages.
Interprets and evaluates medical reports to determine if they are applicable to the claim; monitors legal and medical billings and investigates for proper charges and pays accordingly.
Negotiates settlements with individuals, attorneys, and other insurance carriers within their granted settlement authority level.
Pursues subrogation and may arrange for salvage to obtain the maximum recovery.
Prepares detailed scope of damages on property losses and brings to resolution.
Assists, when requested, in the selection and evaluation of experts as needed.
Manages litigation, checking to ensure that coverages are not exceeded, that legal expenses are adequate, and confers with attorney about case direction and disposition.
Will participate in special projects or training programs.
Successfully completes all required training and applies.
Will assist in the training of Claims Service Specialists III and below.
Will keep management informed of activities and issues within assigned area of responsibility.
Performs other related duties as required or requested.
Excellent customer service, communication and time management skills
3-5 years of equivalent work related experience.
2 or more years as a Claims Service Specialist III
Demonstrated success in handling PIP, BI and MD2