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is a premier provider of insurance, risk management, alternative risk, pool administration and claims management solutions to clients across hundreds of industries. Recently named by Forbes as one of"America's Best Midsized Companies Two Years in a Row"We firmly believe that our employees drive the success of the company. With success in mind as the ultimate goal, we strive to create and provide an environment that offers challenging, stimulating and financially rewarding opportunities.
The role of the Casualty Claims Adjuster is to investigate, evaluate and adjust Commercial General and Automobile Liability claims. Although assigned claims generally consist of low to medium exposure, first and third party automobile bodily injury and property damage claims, as well as premises liability accidents, product liability claims, the casualty claims adjuster must be qualified legally and technically to handle all claims competently.
Evaluate insurance coverage based on claim report, the insurance policy and applicable statutes and case law to determine if a claim can be accepted as being within coverage.
Interviews, telephones, and/or corresponds with claimant and witnesses; obtains and reviews police hospital records, appraisals and repair estimates to evaluate injuries property damage; Reports to client as required by contractual account instructions; utilize appropriate methods of investigation according to type of coverage
Obtain, review and evaluate medical records.
Identify key coverage, damage and liability issues and plan investigation as required in accordance with contractual obligations and prevailing professional standards.
Comply with all statutory and regulatory requirements of all applicable jurisdictions.
Meet detailed quality assurance standards of performance
Obtain and keep in effect all required licenses and certifications and meet all continuing training and certification requirements.
Determine extent of the client’s financial exposure with respect to claims; set case reserves for use by clients and applicable regulatory authorities
Revise case reserves based on developments in the course of adjusting the claims
Be alert to insurance fraud and implement special procedures if possible fraud is detected.
Settle claims within assigned levels of authority as set forth in client account instructions
Select and manage experts with limited input from supervisor
Work with and provide claim-specific guidance to Field Adjuster.
Involve client in decision-making as appropriate and/or follow client-specific requirements for escalation when client decision-making and/or notification is required.
Interact successfully with co-workers
Other duties as assigned
Excellent negotiation skills
Excellent oral and written communication and presentation skills
Analytical and interpretive skills
Strong organizational skills
Solid interpersonal skills
Strong customer service skills
Able to multitask
Capable of setting priorities
Works well under pressure
Spanish fluency is a plus
In-depth knowledge of multi-jurisdictional claims handling issues
PC literate, including Microsoft Office products
BS / BA or Equivalent Work Experience
Licenses as required
Extensive knowledge of investigation management including, but not limited to, taking and using recorded statements, determining coverage and application of coverage to claims, delivering case value and negotiation and resolution of claims.
Minimum of 3-5 years of industry experience in Property and Casualty Claims
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