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Role Description

The purpose of this position is to provide direct handling of the company’s non-litigated and lower-level litigated Auto and/or general liability claims. These claims should not involve any major coverage issues. Position may also handle non-litigated UM/UIM claims. Responsibilities of this position include basic coverage analysis, investigation, evaluation, negotiation, and disposition of assigned claims. The individual in this position will also ensure claims are processed within company policies, procedures, and with the individual’s prescribed authority with exceptional standards of performance. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements.

Responsibilities

• Investigate coverage and liability of claims through telephone, automated correspondence, and/or personal contact with claimants, attorneys, insureds, witnesses, and others having pertinent information. Issue applicable coverage letters.
• Analyze information in order to evaluate assigned claims to determine the extent of loss, taking into consideration contributory or comparative negligence. Assign medical or other experts to case and arrange for medical examinations when necessary.
• Process incoming calls and correspondence from insureds, claimants and agents regarding questions or problems associated with claims. Interact with underwriters and agents on claim resolution.
• Evaluate, negotiate, and resolve claims within delegated authority. Handle general liability and auto liability files from start to finish. Assign appropriate counsel if needed to defend a claim.
• Update claims system on a continual basis to accurately reflect status of each assigned file and to initiate percentage of negligence on the part of the insured to determine "chargeability".
• Receive and approve expenses incurred to investigate, process, and handle a claim.
• Close claim by issuing check or denial and securing appropriate releases. Prepare check requisitions for all loss and expense payments.
• Explore contribution on all claims assigned.
• Prepare for and participate in claims review and settlement conferences.
• Analyze information, including depositions, expert reports, attorney evaluations, and medical reports, gained from discovery during litigation in order to evaluate assigned claims to determine the extent of loss, taking into consideration contributory or comparative negligence.
• Investigate damages, coverage, and liability related to a claim through telephone, automated correspondence, and/or personal contact with claimants, attorneys, insureds, witnesses, and others having pertinent information. Issue applicable letters based on state regulations and company directives, including coverage and status letters.
• Review and approve expenses incurred to investigate, process, and handle a claim.
• Assign appropriate counsel if needed to defend a claim. Attend/participate in depositions and trials as necessary.
• Recognize fraudulent claims activity that would be subject to SIU referral in accordance with company guidelines and subsequent referral to law enforcement or regulatory agencies.
• Document claim activity and maintain control of work through documentation and diary/task system.
• Establish and continuously review reserves.

Qualifications

• Effective verbal and written communication skills.
• Strong time management and organizational skills.
• Negotiation and claim disposition skills with proven problem-solving ability.
• Strong judgment and decision-making skills.
• Self-starter with ability to work independently.
• Moderate proficiency with standard business-related software.

Requirements

• College degree preferred: A degree in Business, Insurance, Risk Management, or a related field is highly preferred.
• Minimum of 3 years of prior Commercial General Liability claims experience with a primary insurance carrier: Experience must include handling a significant volume of claims independently.
• Experience handling GL Claims in the Mid-Atlantic jurisdictions, preferred.
• Strong knowledge of insurance policies, procedures, and regulations: Must demonstrate in-depth knowledge through certifications (e.g., CPCU, AIC) or extensive work experience.
• Demonstrated ability to analyze complex coverage issues: Must provide examples of complex coverage issues handled and the resolutions achieved.
• Experience with Professional Liability claims is a plus but not required.
• Litigation experience is a plus but not required.
• Industry training/designations preferred: Designations such as CPCU (Chartered Property Casualty Underwriter), AIC (Associate in Claims), or similar are preferred.

Benefits

• Competitive base salary.
• Incentive plan eligibility at all levels.
• Comprehensive health care plans.
• Retirement savings plan with company match.
• Discounted Employee Stock Purchase Program.
• Tuition assistance and reimbursement programs.
• 20 days of paid time off.