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Melville, NY
(Click company name to view employer profile and all available positions.)
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| Career Field |
Claims
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| Insurance Discipline |
All
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| Relocation Assistance |
Not Available
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| Job Duration |
Full Time |
| Salary Offered |
Open
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** Open House November 18 3 pm -7pm **
SUMMARY:
Investigate, evaluate, reserve, negotiate and settle assigned claims in accordance with Best Practices. Provide quality claim handling and superior customer service on assigned claims, while engaging in indemnity & expense management. Promptly manage claims by completing essential functions including contacts, investigation, damages development, evaluation, reserving, litigation management, and disposition.
PRIMARY DUTIES:
Timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case. Consult with Unit Manager on use of Claim Coverage Counsel.
Investigate each claim through prompt contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Take necessary statements.
Identify resources for specific activities required to properly investigate claims such as outside claim representatives, nurse consultants, and fire or fraud investigators and to other experts. Request through Unit Manager and coordinate the results of their efforts and findings.
Verify the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation.
Keeps effective diary management system to ensure that all claims are handled timely. At required time intervals, evaluate liability & damages exposure, and establish proper indemnity & expense reserves. Utilize evaluation documentation tools in accordance with department guidelines.
Responsible for prompt and proper disposition of all claims within delegated authority. Negotiate disposition of claims with insureds and claimants or their legal representatives. Recognize and implement alternate means of resolution
May manage litigated claims. Develop litigation plan with staff or panel counsel, track and control legal expenses. Assure cost-effective resolution.
Attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
Maintain claim files, have an effective diary system, and document claim file activities in accordance with established procedures.
Update appropriate parties as needed, providing new facts as they become available, and their impact upon the liability analysis and settlement options.
Recognize cases based on severity protocols to be referred to next level claim handler or Major Case Unit and refer on a timely basis.
Appropriately deal with information that is considered personal and confidential.
Compliance with Claim Department's 'Best Practices'.
Fulfill specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC) instructions, and inquires from agents and brokers.
Handles moderate to complex litigation
Manage litigation expenses and payout.
Leverages relationships with plaintiff's counsel
EDUCATION/COURSE OF STUDY:
College degree or equivalent in business discipline preferred
CERTIFICATES/DEGREES:
State license where applicable & continuing education
OTHER:
Advanced level knowledge and skill in claims and litigation.
Basic working level knowledge and skill in various business line products.
Strong negotiation and customer service skills
File management
Technical skills
Customer focus/communication
Relationship Management
Technology
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