ESIS Claims Specialist, AGL

Chubb•Simsbury, CT

10d

About The Position

The AGL Claims Specialist, under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably, and within established best practices guidelines. This role involves a comprehensive review of claim and policy information, conducting interviews, evaluating liability, preparing reports, setting reserves, and maintaining strong customer relations. Depending on the line of business, duties may also include managing medical bill payments, vocational rehabilitation, and participating in claim file reviews.

Requirements

Investigate and settle claims promptly, equitably, and within established best practices guidelines.
Determine the extent of the policy’s obligation to the insured.
Secure necessary claim information through interviews and statements.
Evaluate facts to determine liability and company obligation.
Prepare reports on investigations, settlements, and denials.
Set reserves and recommend reserve changes.
Communicate claim status and problems with Team Leader.
Identify and report unusual exposures.
Settle claims and obtain necessary documentation.
Issue claim payments.
Inform parties of claim denials.
Assist in trial preparation and settlement efforts.
Refer claims for subrogation and recovery proceedings.
Participate in claim file reviews and audits.
Administer benefits.
Maintain control of claim resolution.
Establish and maintain customer relations.

Nice To Haves

Experience in commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance.
Familiarity with Chubb's underwriting excellence, superior claims handling expertise, and global operations.

Responsibilities

Receive claim assignments.
Review claim and policy information to provide background for investigation and determine the extent of the policy’s obligation to the insured.
Contact, interview, and obtain statements from insureds, claimants, witnesses, physicians, attorneys, police officers, etc., to secure necessary claim information.
Inspect and appraise damage for property losses or arrange for such appraisal.
Evaluate facts supplied by investigation to determine the extent of liability of the insured and the company’s obligation under the policy contract.
Prepare reports on investigation, settlements, and denials of claims.
Set reserves within authority limits and recommend reserve changes to the Team Leader.
Review progress and status of claims with the Team Leader and discuss problems and suggested remedial actions.
Prepare and submit unusual or possible undesirable exposures to the Team Leader.
Assist the Team Leader in developing methods and improvements for handling claims.
Settle claims promptly and equitably.
Obtain releases, proofs of loss, or compensation agreements and issue company drafts in payment for claims.
Inform claimants, insureds/customers, or attorneys of claim denials when applicable.
Assist the Team Leader and company attorneys in preparing cases for trial by arranging for witness attendance and taking statements.
Continue efforts to settle claims before trial.
Refer claims to subrogation as appropriate.
Arrange for salvage disposition or other recovery proceedings as necessary.
Participate in claim file reviews and audits with customer/insured and broker.
Administer benefits timely and appropriately.
Maintain control of the claim’s resolution process to minimize current exposure and future risks.
Establish and maintain strong customer relations.
Maintain system logs (depending on line of business).
Investigate compensability and benefit entitlement (depending on line of business).
Review and approve medical bill payments (depending on line of business).
Manage vocational rehabilitation (depending on line of business).