About Travelers

The Travelers Companies, Inc. (NYSE: TRV) is a leading property casualty insurer selling primarily through independent agents and brokers. The company's diverse business lines offer its global customers a wide range of coverage in the auto, home and business settings. A component of the Dow Jones Industrial Average, Travelers has more than 30,000 employees and generated revenues of approximately $25 billion in 2010.

Claim Rep Auto

Company Information
Solid reputation, passionate people and endless opportunities. That's Travelers. Our superior financial strength and consistent record of strong operating returns mean security for our customers - and opportunities for our employees. You will find Travelers to be full of energy and a workplace in which you truly can make a difference.

Job Summary
Under moderate supervision, this position typically handles 1st and 3rd party Personal and Business Insurance Auto Damage, First Party Medical, and Bodily Injury Liability claims from the first notice of loss through resolution/settlement and payment process. Provide quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This job does not lead others.

Primary Job Duties & Responsibilities
Customer Contacts/Experience: Deliver consistent service quality throughout the claim life cycle, including but not limited to prompt contact, explaining the process, setting expectations, on-going communication, follow-through and meeting commitments to achieve optimal outcome on every file. Fulfill specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC). Coverage Analysis: Review and analyze coverage and apply policy conditions, provisions, exclusions and endorsements, and how jurisdictional issues impact the claim. Verify the benefits available, the injured party's eligibility and the applicable limits. Address proper application of any deductibles, co-insurance, coverage limits, etc. Confirm priority of coverage i.e.: primary, secondary, concurrent or not applicable, and take into consideration other issues such as Social Security, Workers Compensation or others relevant to the jurisdiction. Investigation/Evaluation: Investigate each claim to obtain relevant facts necessary to determine coverage, causation/damages, extent of liability/establishment of negligence, damages, contribution potential and exposure with respect to the various coverages provided through prompt contact with appropriate parties (eg. policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts). This may also include investigation of wage loss and essential services claims including verification of coverage, employment, loss of income due to accident and medical disability to support wage loss or need for essential services to ensure validity of the claim. Take necessary statements. Recognize and request appropriate inspection type based on the details of the loss and coordinate the appraisal process. Maintain oversight of the repair process and ensure appropriate expense handling. On specified claims, proactively monitor medical treatment based on the nature and extent of injury, mechanism of injury, type of treatment received or anticipated, and wage loss through case management and use of medical resources as needed. Monitor the process to ensure proper payment, (i.e.: review medical bills and medical records for appropriateness of billing/fees and the services rendered ensuring that all records have a determination of medical necessity and causal relationship to the loss.) Reserving: Establish timely and maintain appropriate claim and expense reserves. Manage file inventory and expense reserves by utilizing an effective diary system, documenting claim file activities to resolve claim in a timely manner. Negotiation/Resolution: Determine settlement amounts, negotiate and convey claim settlements within authority limits to insureds and claimants. As appropriate, write denial letters, Reservation of Rights and other necessary correspondence to insureds and claimants. May handle litigated files on appropriately assigned cases. Develop resolution plan with staff or panel counsel, and track and control legal expenses; Review conciliations and prepare submissions for arbitration and/or mediation hearings. May also attend arbitrations as Company witness. Attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. Recognize and forward appropriate files to subject matter experts (i.e.: SIU, staff counsel, property, etc.). Identify subrogation opportunities, determine appropriateness of the demand and negotiate adverse subrogation and arbitration. Recognize cases based on severity protocols to be referred timely to next level claim professional. Other duties as assigned.

Education, Work Experience & Knowledge
High School Degree or GED. College degree or equivalent business experience preferred. Prior claim handling experience a plus.

Job Specific & Technical Skills & Competencies
Strong keyboard skills and Windows proficiency, including Excel and Word. Demonstrated ownership attitude and customer centric response to all assigned tasks. Strong verbal and written communication skills. Attention to detail ensuring accuracy. Ability to work in a high volume, fast paced environment managing multiple priorities Competency Levels: Analytical Thinking- Intermediate Judgment/Decision Making- Intermediate Communication- Intermediate Negotiation- Intermediate Insurance Contract Knowledge- Intermediate Principles of Investigation- Intermediate Value Determination- Basic Settlement Techniques- Basic Medical Knowledge- Basic

Physical Requirements
Operates standard office equipment Requires extended periods of computer use Requires extended periods of sitting

Equal Employment Opportunity Statement
Travelers is an equal opportunity employer.
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