ESIS Claims Specialist, AGL

Chubb•Tampa, FL

About The Position

Under limited supervision, this role involves receiving assignments and reviewing claim and policy information to provide background for investigation. The specialist will determine the extent of the policy's obligation to the insured depending on the line of business. This includes contacting and interviewing insureds, claimants, witnesses, physicians, attorneys, and police officers to gather necessary claim information. For property losses, the specialist may inspect and appraise damage or arrange for such appraisal. The role requires evaluating investigation findings to determine the insured's liability and the company's obligation under the policy contract. Responsibilities also include preparing reports on investigations, settlements, and claim denials, setting reserves within authority limits, and recommending reserve changes. The specialist will review claim progress and status with the Team Leader, discuss problems and suggest solutions, and submit unusual or potentially undesirable exposures. Assisting the Team Leader in developing claim handling methods and improvements is also part of the role. The specialist will settle claims promptly and equitably, manage litigated files by directing defense counsel, obtain releases and proofs of loss, issue claim payments, and inform claimants, insureds, or attorneys of claim denials when applicable.

Requirements

Minimum of 7 years claims handling experience in specific line of business (Auto & General Liability).
Required to obtain specific state licenses.
Knowledge of coverages.
Good understanding of applicable legal principles and litigation management.
Knowledge of auto liability cost containment programs.
Proven account management skills.
Strong litigation management skills.
Excellent communication, negotiation and interpersonal skills to effectively interact with all levels of an organization both internal and external.
Strong analytical and problem solving ability.
Demonstrated ability to provide consistent superior service to customers.

Nice To Haves

Experience within a TPA environment strongly preferred.

Responsibilities

Receives assignments and reviews claim and policy information to provide background for investigation.
Determines the extent of the policy’s obligation to the insured depending on the line of business.
Contacts, interviews and obtains statements from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
Inspects and appraises damage for property losses or arranges for such appraisal.
Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extend of the company’s obligation to the insured under the policy contract.
Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc.
Sets reserves within authority limits and recommends reserve changes to Team Leader.
Reviews progress and status of claims with Team Leader and discusses problems and suggested remedial actions.
Prepares and submits to Team Leader unusual or possible undesirable exposures.
Assists Team Leader in developing methods and improvements for handling claims.
Settles claims promptly and equitably.
Manages litigated files by directing defense counsel to ensure best possible outcomes.
Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.
Informs claimants, insureds/customers or attorney of denial of claim when applicable.