Claims Specialist

• Investigate, evaluate, provide defense if appropriate, negotiate and resolve assigned property damage and bodily injury claims
• Identify information and documents needed to evaluate claims
• Assign and direct independent adjusters
• Review public and other records and documents
• Contact insureds, claimants and others regarding claim information, processes, resolution alternatives and related matters
• Comply with claims handling laws and regulations
• Engage defense counsel when appropriate and monitor defense of insureds at higher levels
• Identify, evaluate and determine rights and obligations under applicable insurance contracts
• Coordinate with the Legal Department on coverage, compliance and legal issues
• Analyze, evaluate and estimate insured liability and claimant/insured losses
• Identify and report potential fraud to the Special Investigation Unit
• Evaluate claim settlement scenarios using decision theory principles
• Establish and modify appropriate case reserves
• Review and approve or disapprove invoices
• Maintain and review claim diaries
• Negotiate and resolve claims within established authority or submit authority requests and recommendations
• Maintain accurate communication records and appropriate claim files
• Provide assigned-claim information to managers and others as required
• Maintain current knowledge of insurance and claim management principles and practices

Senior Claims Examiner

• Investigate assigned property damage and bodily injury claims reported under affiliated Companies' insurance contracts
• Identify information and documents needed to evaluate claims
• Assign and direct independent adjusters and review public and other records and documents
• Contact Insureds, Claimants and others regarding information, claim processes, resolution alternatives and related matters
• Comply with claims handling laws and regulations
• Engage defense counsel and monitor defense of Insureds at higher levels, or work with internal legal counsel
• Analyze and determine rights and obligations under applicable insurance contracts
• Coordinate with the Legal Department on coverage, compliance and legal issues
• Analyze, evaluate and estimate liability and losses
• Identify and report potential fraud to the Special Investigation Unit
• Use decision theory principles to evaluate claim settlement scenarios
• Establish and modify appropriate case reserves
• Review and approve or disapprove invoices for allocated loss adjustment expenses
• Maintain and review claim diaries and claim files
• Negotiate and resolve assigned claims within established authority or recommend resolution to management
• Prepare and maintain accurate records of communications and required claim documentation
• Maintain current knowledge of insurance and claim management principles through professional literature, opinions, periodicals and conferences