Claims Adjuster (MI PIP and MED Only)

Frankenmuth Insurance Company

About The Position

Under general supervision and following standard procedures with independent judgment, the Claims Adjuster investigates, evaluates, and resolves Michigan PIP and Med Pay claims to determine the extent of company liability. This may include determining and evaluating coverage, compensability, liability, and damages in accordance with policy provisions. The role follows corporate policies, procedures, and fair claims handling practices; investigates claims; evaluates documentation; sets or recommends reserves; and manages, evaluates, and concludes claims within defined authority. The adjuster maintains claim reports, monitors claim outcomes through self-audits, and delivers customer service to policyholders and agents to support appropriate and timely resolution of service issues. The position ensures compliance with legal, regulatory, and fair claims handling requirements. The role may involve substantial interaction with insureds, agents, claimants, attorneys, and other service providers, including in-depth interviews, scene inspections, settlement conferences, and trials. The adjuster may contribute to project teams and may train and guide junior staff or provide management with input regarding their performance. Other duties may be assigned.

Requirements

One to three years of related experience and/or training, or an associate's degree from a two-year college or technical school, or an equivalent combination of education and related experience/training.
Ability to work legally in the United States; visa sponsorship or support is not available, including for a U.S. permanent residency (green card) process.
Ability to perform the essential duties satisfactorily, with reasonable accommodations available for individuals with disabilities.

Responsibilities

Follow corporate policies, procedures, and fair claims handling practices.
Investigate claims to determine validity and the extent of liability.
Obtain information needed to investigate and evaluate cases by corresponding with agents, insureds, claimants, witnesses, and others.
Review and evaluate documentation, including applications, reports, and statements.
Monitor appropriate claim outcomes through a self-audit process.
Provide customer service to policyholders and agents and ensure appropriate, timely resolution of claims service issues.
Ensure legal, regulatory, and fair claims handling compliance.
Set or recommend reserves based on claim investigation results.
Manage, evaluate, and conclude claims within defined authority.
Prepare and maintain claim reports.
Conduct in-depth interviews and/or scene inspections when required.
Attend settlement conferences and/or trials when required.
Contribute to project teams and their objectives when assigned.
Train and guide junior staff and provide input to management regarding junior staff performance when applicable.
Perform other duties as assigned.