ESIS Senior Claims Representative, AGL

Chubb•Tampa, FL

11d

About The Position

Under limited supervision, this role involves receiving assignments and reviewing claim and policy information to provide background for investigation. The representative may determine the extent of the policy's obligation to the insured depending on the line of business. This involves contacting, interviewing, and obtaining statements from insureds, claimants, witnesses, physicians, attorneys, and police officers to gather necessary claim information. Depending on the line of business, the role may also involve inspecting and appraising property damage or arranging for such appraisals. The representative evaluates investigation findings to determine the extent of the insured's liability and the company's obligation under the policy contract. Responsibilities include preparing reports on investigations, settlements, and claim denials, setting reserves within authority limits, and recommending reserve changes to the Team Leader. The role also involves reviewing claim progress with the Team Leader, discussing problems and remedial actions, and submitting unusual or potentially undesirable exposures. Additionally, the representative assists the Team Leader in developing claims handling methods and improvements, settles claims promptly and equitably, obtains necessary documentation, and issues claim payments. The role also includes informing claimants, insureds/customers, or attorneys of claim denials when applicable.

Requirements

Limited supervision required.
Ability to determine the extent of policy obligation.
Skill in obtaining statements from various parties.
Ability to inspect and appraise property damage or arrange for appraisal.
Proficiency in evaluating facts to determine liability and company obligation.
Experience in preparing investigation and settlement reports.
Ability to set reserves within authority limits.
Skill in reviewing claim progress and discussing issues with Team Leader.
Ability to identify and report unusual exposures.
Capability to assist in developing claims handling improvements.
Proficiency in settling claims promptly and equitably.
Ability to obtain necessary claim documentation.
Skill in issuing claim payments.
Ability to communicate claim denials effectively.

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 (recorded or in person) 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.
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.