Claims Representative I (General Liability)

Society Insurance Company•Fond du Lac, WI

5d•Hybrid

About The Position

Society Insurance is seeking a Claims Representative I (General Liability) to join our team. This role will investigate, evaluate, and resolve mildly complex General Liability claims by determining coverage and liability, investigating losses, and negotiating appropriate claim resolutions in accordance with company guidelines, policy provisions, and state regulations. Handles and settles mildly complex claims by determining insurance carrier’s liability; reaching agreement with claimants/injured workers according to policy provisions and authority level; and handling subrogation. Determines insurance coverage by examining claim forms, policies, and other records; interviewing claimants/injured workers, insureds, and witnesses; reviewing police and hospital records; and consulting with experts when appropriate. Resolves questionable claims by investigating and comparing claims information with evidence. Ensures company guidelines and procedures are followed during investigations and in the handling of discovery and settlement. Ensures proper file documentation by complying with claims handling guidelines and state requirements. Prepares reports by collecting, analyzing, and summarizing claim information. Develops and maintains professional, technical knowledge and expertise in a specified line(s) of business through training courses and participating in continuing education coursework/classes. Contributes to team effort by participating in determining department investigation guidelines; and providing feedback to underwriting as needed.

Requirements

Bachelor’s Degree in business or related field.
OR 3+ years of claims handling experience involving the exercise of discretionary decision-making as determined by Society Insurance.
OR 5+ years of knowledge in the property & casualty insurance industry.
Familiarity with PC applications including word processing, Internet, spreadsheets, and e-mail software.
Ability to obtain and maintain proper licensing prior to handling a state that requires it.
Valid driver’s license and a satisfactory driving record as determined by Society Insurance.

Nice To Haves

Professional insurance designations highly desirable.

Responsibilities

Handles and settles mildly complex claims by determining insurance carrier’s liability; reaching agreement with claimants/injured workers according to policy provisions and authority level; and handling subrogation.
Determines insurance coverage by examining claim forms, policies, and other records; interviewing claimants/injured workers, insureds, and witnesses; reviewing police and hospital records; and consulting with experts when appropriate.
Resolves questionable claims by investigating and comparing claims information with evidence.
Ensures company guidelines and procedures are followed during investigations and in the handling of discovery and settlement.
Ensures proper file documentation by complying with claims handling guidelines and state requirements.
Prepares reports by collecting, analyzing, and summarizing claim information.
Develops and maintains professional, technical knowledge and expertise in a specified line(s) of business through training courses and participating in continuing education coursework/classes.
Contributes to team effort by participating in determining department investigation guidelines; and providing feedback to underwriting as needed.