ESIS Claims Specialist, AGL

Chubb • Philadelphia, PA

2d

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. Duties may include receiving assignments, reviewing claim and policy information to provide background for investigation, and determining the extent of the policy's obligation to the insured depending on the line of business. The role involves contacting and interviewing individuals to secure necessary claim information, inspecting and appraising damage for property losses or arranging for such appraisal, and evaluating facts to determine liability and the company's obligation. The specialist will prepare reports, set reserves, review claim progress with the Team Leader, and assist in developing methods for handling claims. They will settle claims, obtain releases, and issue payments, while also informing claimants of claim denials when applicable. The role may involve assisting in preparing cases for trial, referring claims to subrogation, arranging for salvage disposition, and participating in claim file reviews. Administering benefits, maintaining control of the claims resolution process, and establishing strong customer relations are key aspects. Depending on the line of business, additional duties may include maintaining system logs, investigating compensability and benefit entitlement, reviewing and approving medical bill payments, and managing vocational rehabilitation.

Requirements

• College degree or 7+ years’ experience handling claims in a relevant line of business, including Construction Defect claims.
• Basic knowledge of claims handling and familiarity with claims terminologies.
• Effective negotiation skills.
• Strong communication and interpersonal skills to be capable of dealing with claimants, customers, insureds, brokers, attorneys etc. in a positive manner concerning losses.
• Ability to self-motivate and work independently.
• Knowledge of company products, services, coverage and policy limits, along with awareness of the company’s claims best practices.
• Knowledge of applicable state and local laws.
• Ability to obtain necessary license.

Responsibilities

• Investigates and settles claims promptly, equitably, and within established best practices guidelines.
• Reviews claim and policy information to provide background for investigation and determine the extent of the policy’s obligation to the insured.
• 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 and extent of the company’s obligation to the insured under the policy contract.
• Prepares reports on investigation, settlements, denials of claims, and individual evaluation of involved parties.
• 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 unusual or possible undesirable exposures to Team Leader.
• Assists Team Leader in developing methods and improvements for handling claims.
• Settles claims promptly and equitably.
• Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.
• Informs claimants, insureds/customers or attorneys of denial of claim when applicable.
• Assists Team Leader and company attorneys in preparing cases for trial by arranging for attendance of witnesses and taking statements.
• Continues efforts to settle claims before trial.
• Refers claims to subrogation as appropriate.
• Arranges for salvage disposition or other recovery proceedings as necessary by line of business.
• Participates in claim file reviews and audits with customer/insured and broker.
• Administers benefits timely and appropriately.
• Maintains control of claim’s resolution process to minimize current exposure and future risks.
• Establishes and maintains strong customer relations.
• Maintains system logs.
• Investigates compensability and benefit entitlement.
• Reviews and approves medical bill payments.
• Manages vocational rehabilitation.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree