Role Description
The Claims Specialist investigates, evaluates, negotiates, and resolves litigated and non-litigated property damage, personal and advertising injury, and claims of medium exposure and complexity. This individual will work under limited supervision, with a remote manager.
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Analyze coverage, identify coverage issues, and prepare coverage letters for supervisor approval
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Investigate and evaluate liability
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Investigate and evaluate damages
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Manage litigation by assigning counsel from the approved panel where applicable, establish litigation plan and budget, coordinate with defense counsel, and continuously review the potential for resolution
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Establish timely reserves within authority and re-evaluate throughout the life of the claim
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Maintain up-to-date, appropriate file documentation and written file notes
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Maintain an active diary and productive file inventory
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Timely completion of all required large loss reporting
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Negotiate settlements within authority limit granted, and attend mediations, Mandatory Settlement Conferences, and/or Alternative Dispute Resolutions
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Proactively control the work product and expense of outside vendors
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Develop and maintain positive customer relationships and provide superior customer service
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Timely identify all potential opportunities for co-insurance, transfer of risk and/or subrogation
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Ability to work with designated assigned accounts
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Recognize and investigate fraud
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Comply with deductible/self-insured retention recovery protocol
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Meet and maintain all State licensing requirements at all times
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Adhere to all statutory regulations, Unfair Claims Practices acts, and corporate Best Practices
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All other duties as assigned
Qualifications
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Four (4) year College Degree, or commensurate experience and training
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AIC, SCLA, CRIS or other similar industry designations preferred
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3-5 or more years claims handling experience or equivalent experience
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In-depth knowledge of the insurance industry, including legal and regulatory environments
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A strong functional and developing knowledge of substantive laws and legal procedures
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Applicable adjusters license(s) to include: CA, CT, DE, FL, KY, LA, NH, NM, NC, OK, RI, SC, TX, VT, WV, WY
Requirements
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Sponsorship not Offered for this Role