Claim Representative III - Casualty

Capital Insurance Group•Roseville, CA

55d•Hybrid

About The Position

The primary purpose of a Claim Representative III - Casualty is to investigate, evaluate, and resolve commercial and personal lines casualty claims. Specific emphasis should be given to analyzing complex coverage issues, duties to defend, larger exposure bodily injuries, negotiating and directing outside counsel. Focus on managing expenses and understanding personal and commercial line policies, including issuance of Reservations of Rights. Demonstrates superior claim service and produces appropriate claim settlements to our clients. It is incumbent upon this individual to understand regulations and the jurisdiction(s) involved in the claims being evaluated.

Requirements

Bachelors degree and four to six years casualty claim handling experience or equivalent experience of six to eight years of claim experience, including three years experience in handling complex claim files.
Knowledge of Current claims laws, specifically civil and tort law and current trends in
Good working knowledge of mathematics and common accounting practices which relate to gross and net income or living-expense calculations.
Proven ability to comprehend contracts pertaining to relationships amongst insured parties and/or landlord/tenant/property management.
Demonstrate strong negotiation skills and communicate complex legal concepts and policy-contract interpretation in writing and orally
Plan, organize, and prioritize work under the pressure of critical deadlines
interpretation in writing and orally
Maintain a valid California Driver License and operate a vehicle

Responsibilities

Individual contributor with advanced understanding to monitors and supervises complex and large exposure claims. Investigates at the loss site. Evaluates the loss, coverage and exposure. Identifies questionable or inconsistent information
Manage and direct mid to high complexity litigated files, working with panel and plaintiff counsel.
Documents claim files accurately and thoroughly and composes reports, correspondence and documentation to track and report on the status of individual claims in compliance with reinsurance needs and State DOI regulations.
Settles claims within the scope of the Companys contractual and legal obligations to ensure that settlements are fair and equitable to the insured, the claimant, and the Company. Determines the extent of damages formulates and communicates settlement offers based on evaluation of liability and coverages, within delegated authority.
Establishes and monitors claims and reserves, to accurately reflect CIGs liability for outstanding losses. Reviews reserves periodically to evaluate based on new evidence or developments in the life of a claim. Reports findings on reserve issues and damages as needed to our reinsures.
Job description is not prescriptive, but rather a guide as to the duties and responsibilities you will have, however it is not limited to the listed above.

Benefits

Accrue twenty-one days of Paid Time Off during your first year
Up to eighty-seven percent of benefits covered by CIG for you and your family members
Medical, dental, vision plans
Basic Life & AD&D
Employee Assistance
Leave Management
Long Term Disability
Short Term Disability (Outside of CA)
Family Caregiver Support (Homethrive)
Child Care Resources (Tootris)
Business Travel Accident Protection
Short-term (CA only)
Voluntary Life AD&D self, spouse and child plans
Flexible Spending
Health Savings (HSA)
Hospital Indemnity
Accidental Injury
Critical Illness
ARAG Legal Services
Norton LifeLock
Nine paid holidays, plus two floating holidays
Above and Beyond Reward Recognition Program
Kudos & Shout Out Points Program
Quarterly Above and Beyond Bonus Program
Annual Above and Beyond Bonus Program
Competitive compensation
Base compensation
Salary Management Spot Bonuses
Annual Incentive/Profit sharing program, potential payout annually based on company results.
Discount partnerships
Gym memberships, credit union, travel, shopping, restaurants, theme parks, and more
Insurance Educational reimbursement and bonus programs
Employee Referral Bonus Program
Home and Auto Insurance Discount Program.
Paid Volunteer Time Through company planned community events and choose your own adventure PVT in giving back in ways that are meaningful to you!
Retirement savings benefit (401k and Roth + match)
Health & Financial Wellness
Wellness platform, tools and events
Health Savings Account match
Financial Wellness Resources