Claims Specialist - Property

TRADEWIND GROUP INC•Honolulu, HI

13h•Onsite

About The Position

Under minimal to no supervision, the Claims Specialist - Property reviews, investigates, evaluates, negotiates, and resolves a variety of multi-line property claims. This role independently handles all aspects of assigned claim inventory in line with department standards, procedures, and appropriate claims practices. The specialist provides superior customer service, manages communications with agents, policyholders, and other involved parties, and determines the most efficient course of action for claim resolution. Key responsibilities include claims intake and assignment, thorough investigation and evaluation of facts of loss, liability, and damages, and negotiation of appropriate settlements. The position also involves financial and system management, including establishing reserves and processing transactions, as well as managing outside vendors and handling complex or litigation claims.

Requirements

High school diploma or general education degree (GED)
3 to 5 years multi-line claims and litigation management experience as a Claim Service Representative
Continuing education in insurance and job-related issues and subjects

Nice To Haves

College degree with credits in insurance related subjects

Responsibilities

Provides superior customer service.
Handles calls from agents, policyholders, and others regarding claims and general company information.
Communicates in a clear, professional, and courteous manner.
Analyzes needs of callers and determines the most efficient course of action for resolution.
Contacts insured and other involved parties.
Communicates status to insureds, claimants, and their attorneys, if any, as required by the Hawaii Revised Statutes and/or on request, in writing or in person, on or off site.
Possesses a positive, service-oriented attitude toward agencies, insureds, and employees within the company.
Receives claim loss information from agencies, insureds, claimants, or other involved parties; and establishes a claim on the computer system.
Determines whether the claim should be handled by the Property Unit or assigned to another unit.
Reviews limited assignments as well as assigned claims for applicable coverage, liability, and exposures.
Determines/confirms facts of loss, liability/3rd party negligence, and extent of damages.
Investigates and determines liability/3rd party negligence.
Obtains recorded statements as needed.
Determines liability based on facts developed and thorough knowledge of the applicable Hawaii Revised Statutes and other applicable laws.
Keeps abreast of the current status of the law, including case law.
Inspects, photographs, and diagrams damages and scene to support claim resolution.
Obtains other documentation, as appropriate, including but not limited to police and fire investigative reports.
Writes or obtains accurate repair estimates, if repairable, or determines cost of replacement, subject to applicable coverage and deductibles.
Applies appropriate depreciation.
Evaluates damages considering applicable coverage, liability determination, and other pertinent information developed in the investigation.
Ensures investigation is thorough and complete and documentation in the file supports the claim.
Negotiates appropriate settlements within authority granted by the supervisor.
Initiates property damage liability deductible recovery procedures where applicable.
Recognizes salvage opportunities.
Secures and disposes of salvage items, recovering an appropriate amount and crediting it to the claim file, or negotiates with the property owner to retain the salvage in exchange for an appropriate credit on the settlement.
Recognizes subrogation opportunities.
Secures and preserves evidence, as necessary.
Refers to subrogation unit for follow-up and collection.
Reviews questionable claims and all coverage issues with supervisor.
Establishes appropriate initial case reserves on the computer system and submits initial Property Insurance Loss Register (PILR) information as assigned.
Processes financial transactions on applicable system including establishing and adjusting reserves, and making payments, within discretionary authority and in a timely manner to avoid additional payments for late fees/interest.
Prepares and submits written requests for authority and other reports, as required by the supervisor.
Documents all assigned claim files for timely follow-up and reviews them in accordance with diary procedures.
Enters timely, clear, and concise notes on applicable computer system to document all activities – investigations, evaluations, recommendations, negotiations, and resolution.
Manages all outside vendors (e.g., independent adjusters, appraisers, contractors, investigators, experts, and attorneys) to minimize the length of time to resolution of the claim and the allocated loss expenses.
Handles complex and/or litigation claims.
Follows prescribed litigation guidelines and procedures including reporting requirements and attorney fee review program.
Attends and participates in mediations, arbitrations (e.g., Inter-Company Arbitration, Court Annexed Arbitration Program, or American Arbitration Association), and settlement conferences, as directed by the supervisor.
Assists with small claims court and subrogation actions, and arbitration filings as directed by the supervisor.
Informs supervisor of all oral and written complaints and all coverage issues.