Casualty Claims Specialist
About The Position
This role involves managing and overseeing casualty claims, including large and complex cases. The specialist will examine claims, determine coverage applicability, maintain claim file reserves, and prepare status reports. Responsibilities also include attending legal proceedings, conducting interviews, negotiating settlements, and assessing claims for subrogation and recovery potential. The specialist will communicate with insureds, agents, and legal representatives, and collaborate with supervisors and other claims staff. Additionally, participation in performance feedback and assisting in training junior adjusters are key aspects of the role, all while ensuring compliance with licensing and fair claims practice laws.
Requirements
- Bachelor’s degree or equivalent education and experience.
- Minimum of 7 years of experience in casualty claims handling
- Well-developed business acumen.
- Ability to multi-task and handle numerous assignments simultaneously.
- A process thinker seeking productivity and exceptional service.
- Excellent verbal, telephone, and written communication skills.
- Ability to work well in a team environment.
- A professional, positive and enthusiastic attitude.
- Advanced computer skills.
- Excellent listening and feedback skills.
- Good problem solving skills.
- Effective training skills.
Nice To Haves
- Bachelor’s degree or equivalent education and experience in a relevant field.
- Valid Claims Adjuster’s license in the State of Vermont and other states when applicable.
- Prefer AIC, CPCU, CIC, or other insurance designations
Responsibilities
- Examine claims forms and records to determine if insurance coverage is applicable, and to what extent coverage is provided.
- Maintain timely and accurate claim file reserves, noting policy limits, deductibles, form endorsement, contract terms, and other essential forms and documents.
- Handle large and complex casualty claims.
- Oversee the adjustment of large, complex or litigated auto or casualty claims.
- Track all open files and prepare regular status reports.
- Attend litigation hearings, depositions and mediations as a Company representative.
- Conduct interviews with insureds/claimants/witnesses, taking recorded statements.
- Correspond with insureds/claimants and/or their legal representatives.
- Consult police and hospital records to gain accurate information regarding the claim.
- Prepare report of findings and negotiate settlement with insured, claimant, attorney and/or other representative, explaining coverage as it applies to settlement.
- Compile all documentation and reports to ensure an accurate and complete claim file.
- Assess claim in consideration of subrogation, salvage and recovery, depreciation, replacement costs, restitution, estimates of independent contractors, estimating software, and other tools provided.
- Communicate with insured and agent during the claim investigation and settlement.
- Confer regularly with supervisors, other claims staff and other Company personnel to plan and coordinate activities, exchange information, resolve problems, etc.
- Participate in monthly Claims Monitoring for performance feedback; adjust performance based on feedback.
- Assist supervisors in training new claims adjusters and in overseeing the daily work of junior adjusters.
- Act in compliance with all licensing, fair claims practice laws and regulations.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
