Claims Representative II

Society Insurance Company•Fond du Lac, WI

113d•Remote

About The Position

Society Insurance is seeking a Claims Representative II who excels at managing moderate-to-complex bodily injury and general liability claims. This role focuses on investigating losses, determining liability, and negotiating out-of-court settlements for mildly complex general liability claims. Successful candidates will have experience handling represented bodily injury claims, with a strong emphasis on Commercial General Liability (CGL) and premises liability exposures, along with the judgment and negotiation skills needed to navigate matters that advance into litigation.

Requirements

Bachelor’s Degree and 3+ years of claims handling experience OR 5+ years of claims handling experience.
Proficiency in general liability claims demonstrated through knowledge and experience in insurance policies and coverage, claim payment procedures, insurance regulations, and legal terminology.
Ability to obtain and maintain proper licensing prior to handling a state that requires it.

Nice To Haves

Professional insurance designations highly desirable.
Litigation experience highly desirable.
Experience using Guidewire Claims System highly desirable.

Responsibilities

Settles mildly complex claims by determining insurance carrier’s liability and reaches agreement with claimant according to policy provisions and authority level.
May be involved with litigation by analyzing negotiated settlement options; evaluating evidence, and overseeing attorney in the handling of discovery and settlement.
Handles mediations, arbitrations, subrogation, and recorded settlement agreements.
Determines coverage through investigations by examining claim forms, policies, and other records; interviewing claimants, insureds, and witnesses; consulting police and hospital records; inspecting damages; and consulting with experts when appropriate.
Mentors and trains claims representatives in claims expertise by assisting in identifying training needs and opportunities.
Resolves questionable claims by investigating the claim and comparing claims information with evidence.
Ensures proper file documentation of assigned files by complying with company and state requirements.
Prepares reports by collecting, analyzing, and summarizing claim information.
Contributes to team effort (as needed) by participating on catastrophe teams; participating in determining department investigation guidelines; providing feedback to underwriting as needed.