ESIS Senior Claims Representative, AGL

Chubb•Alpharetta, GA

11h•Onsite

About The Position

Under limited supervision, this role involves 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 representative will contact, interview, and obtain statements from various parties to gather necessary claim information. Depending on the line of business, they may inspect and appraise damage for property losses or arrange for such appraisal. The role requires evaluating gathered facts to determine the insured's liability and the company's obligation under the policy contract. Responsibilities include preparing reports on investigations, settlements, claim denials, and individual evaluations. The representative will set reserves within authority limits, recommend reserve changes, and review claim progress with the Team Leader, discussing issues and suggested remedial actions. Unusual or potentially undesirable exposures are to be submitted to the Team Leader. The role also assists the Team Leader in developing methods and improvements for claims handling, settling claims promptly and equitably, obtaining necessary documentation, and issuing claim payments. Informing claimants, insureds/customers, or attorneys of claim denials is also a key function.

Requirements

5 or more years of experience handling claims, as evidenced by career progression within the company or a similar organization.
Ability to work independently with limited direction from a Team Leader.
Strong technical knowledge of claims handling and claims terminology.
Superior negotiation skills.
Strong communication and interpersonal skills to work effectively with claimants, customers, insureds, brokers, attorneys, and others in a professional manner regarding losses.
Strong knowledge of the company’s products, services, coverages, and policy limits, along with a solid understanding of claims best practices.
Strong knowledge of applicable state and local laws related to the line of business handled.
Superior customer service skills.

Responsibilities

Under limited supervision, receives assignments and reviews claim and policy information to provide background for investigation and may determine the extent of the policy’s obligation to the insured, depending on the line of business.
Contacts, interviews, and obtains statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, and others to secure necessary claim information.
Depending on the line of business, may inspect and appraise damage for property losses or arrange for such appraisal.
Evaluates facts gathered through investigation to determine the extent of liability of the insured, if any, and the extent of the company’s obligation to the insured under the policy contract.
Prepares reports on investigations, settlements, claim denials, and individual evaluations of involved parties.
Sets reserves within authority limits and recommends reserve changes to the Team Leader.
Reviews claim progress and status with the Team Leader and discusses issues and suggested remedial actions.
Prepares and submits unusual or potentially undesirable exposures to the Team Leader.
Assists the Team Leader in developing methods and improvements for claims handling.
Settles claims promptly and equitably.
Obtains releases, proofs of loss, or compensation agreements and issues company drafts for claim payments.
Informs claimants, insureds/customers, or attorneys of claim denials when applicable.