Responsible for the direct supervision of a dedicated claim adjusting unit handling specified line(s) of business, i.e. auto, property or casualty. Direct and monitor the assigned claim adjusting and support personnel to ensure the timely, accurate and fair investigation, evaluation and disposition of all claims assigned to the unit. Claim outcomes must be consistent with policy terms and conditions, damages and legal requirements. Directly manage and oversee the assigned adjusting and support personnel and assure that they adhere to and comply with all Claim File Handling Guidelines and all other job expectations, regulations and requirements.
DUTIES & RESPONSIBILITIES
- Direct and monitor areas of accountability to produce results consistent with policy language, damages and legal requirements.
- Select, develop, motivate, train and retain a competent staff.
- Monitor and review the claim workload and a cross-section of claim files to ensure that productivity levels are met, and that defined quality standards are achieved.
- Assign new losses and review files on diary to ensure reserve adequacy, while providing appropriate file direction to the adjusting staff.
- Monitor loss adjustment expense and take steps to mitigate expenses wherever reasonably feasible.
- Review requests from staff to use vendors and authorize if justified.
- Review coverage questions and provide direction, interpretation and approval.
- Refer appropriate coverage matters to Claim Manager.
- Ensure appropriate file handling, documentation, indemnity and expense control of all files within the unit supervised.
- Provide accurate, courteous and timely information to all external and internal customers concerning claim status and other inquiries.
- Coordinate reporting to reinsurers, E&O carrier, accounting and brokers per protocols.
- Provide service calls to policyholders and agencies as needed.
- Serve as a technical resource within the Department through mentoring and knowledge sharing.
- Draft coverage correspondence, including reservation of rights and coverage disclaimer along with composing detailed correspondence to insureds, claimants, attorneys, etc.
- Attend trials, depositions, EUO’s, appraisals, arbitrations and mediations where strategically advantageous or required by jurisdiction.
- Write and administer timely comprehensive performance appraisals of assigned staff.
- Recommend appropriate salary adjustments based upon actual job performance.
- Suggest improvements to processes within the department, or serve on committees, to increase the level and quality of service provided to internal and external customers, i.e. workflow changes, systems upgrades, etc.
- Participate in setting file direction on complicated or high-exposure matters and recommend appropriate reserves on claim files within specific authority and on files requiring reporting to senior management.
- Confer with claim management, claim representatives, and other company personnel to plan, evaluate goals/objectives, resolve problems, and exchange information.
- Regulate caseloads; produce reports analyzing staffing levels and unit performance.
- Monitor and maintain diaries and task-counts.
- Assume primary or secondary responsibility for strategic functions and projects such as CAT planning/teams, workflow design or systems modifications.
- Evaluate, procure, coordinate and deliver technical training to agents, adjusters and clerical personnel.
- Respond to customer, agency and Insurance Department correspondence.
- This position is expected to directly handle claims, as needed.
- Performs other duties or special projects as required or as assigned.
The Claim Manager provides direct minimal supervision.
The Claim Supervisor may have direct responsibility for a unit potentially comprised of all levels of claim Examiners, Representatives and claim Support staff.
- Bachelor's degree in business, insurance or a related field, or its equivalent.
- Seven or more years of relevant claim supervisory and technical experience with demonstrated achievement and progressive responsibilities.
- Strong knowledge of the technical aspects of property and/or casualty claims (including automobile, general liability, subrogation and litigation).
- Demonstrated ability to train and mentor assigned employees in all technical aspects of their job responsibilities.
- Appropriate state Adjuster’s License(s) where required by law.
- Knowledge of property/casualty insurance claims management processes, systems and regulatory requirements.
- Demonstrated commitment to professional development through continuing education related to the job through the attainment of recognized industry designations such as AIC, AEI, INS or CPCU programs, etc.
- For field based positions, previous outside experience is preferred and valid driver’s license required.
- General understanding of the insurance industry and company operations.
- Highly developed analytical, and negotiation skills.
- Excellent verbal and written communication skills.
- Planning, administrative and supervisory experience.
- Demonstrated ability to exercise good judgment in dealing with professional and personnel situations.
- Demonstrated ability to work effectively with a wide array of outside firms and organizations.
- Demonstrated ability to deal effectively with company management, peers and co-workers.
- Proficiency with PC applications including Microsoft Office (Word, Excel & Outlook); Experience with imaging and estimating programs preferred.
- Ability to perform job responsibilities during stressful circumstances.
PHYSICAL DEMANDS/WORKING CONDITIONS
- Typical office or residence-based environment.
- Predominately sedentary office position with high frequency of keyboarding/computer work required.
- The physical demands are minimal and typical of similar jobs in comparable organizations.
- The work environment is representative and typical of similar jobs in comparable organizations.
- Occasional overnight travel.
- Potentially subject to adverse weather and stressful situations with respect to claim disputes.