Claims-Adj TPLC Rep-Cons II
The world isnt standing still, and neither is Allstate. Were moving quickly, looking across our businesses and brands and taking bold steps to better serve customers evolving needs. Thats why now is an exciting time to join our team. Youll have opportunities to take risks, challenge the status quo and shape the future for the greater good.
Youll do all this in an environment of excellence and the highest ethical standards a place where values such as integrity, inclusive diversity and accountability are paramount. We empower every employee to lead, drive change and give back where they work and live. Our people are our greatest strength, and we work as one team in service of our customers and communities.Plus, Allstate is changing how, when, and where we work-to lead us boldly into our future. We're empowering our employees to create better ways of working through more intentional use of communication and collaboration practices, processes and tools.
Everything we do at Allstate is driven by a shared purpose: to protect people from lifes uncertainties so they can realize their hopes and dreams. For more than 89 years weve thrived by staying a step ahead of whatevers coming next to give customers peace of mind no matter what changes they face. We acted with conviction to advocate for seat belts, air bags and graduated driving laws. We help give survivors of domestic violence a voice through financial empowerment. Weve been an industry leader in pricing sophistication, telematics, digital photo claims and, more recently, device and identity protection. We are the Good Hands. We dont follow the trends. We set them.Job Summary
The Adjusting Function is responsible for verifying policy coverage and limits. The Adjusting function investigates and evaluates damage and/or liability; estimates damages, losses, or total indemnity; sets and maintains reserves; and/or negotiates and settles claims. Third party liability and casualty claims involve coverage and liability investigation, negotiation, and settlement of policyholder and third-party liability, property damage, and bodily injury claims.
Under limited supervision, this job is responsible for investigating complex claims when an attorney is representing the injured party which typically will include: (1) uninsured or underinsured motorist (UM/UIM) claims in single or multi car accidents; (2) Injury Casualty Soft Tissue (ICST), and represented- moderate or major claims; (3) complex Commercial Property Liability (CPL) or extra-contractual liability claims; (4) or specialized claims (e.g., business interruption, loss of income, E&O policies, etc.). The individual also handles claims involved in litigation, arbitration or mediation, coordinating with legal counsel and participating in depositions, hearings, trial, or arbitrations. The individual takes recorded statements, resolves loss of use claims, makes payments to appropriate parties, and negotiates and settles or refers bodily injury issues that cannot be resolved. The individual delivers compassionate service that is fast, fair, and easy, to ensure customer retention while verifying coverage, investigating and determining liability, reviewing and determining damages, and negotiating and settling complex claims. The individual provides work guidance and direction to less senior employees and provides mentoring and coaching to the team. The individual works independently, prioritizing the individual's own responsibilities, and managing the individual's own workload. The individual also consistently meets band level behaviors, production, quality, and/or customer service goals.
- Makes and maintains a connection with the customer by understanding and meeting their needs; serves the customer with empathy; and follows up to ensure that customer needs have been met
- Researches and responds to complex customer communications, concerns, conflicts or issues
- Reviews customer satisfaction results; participates in determining necessary personal and business unit action plans
File Documentation and Reporting
- Summarizes documents and enters into claim system notes
- Documents a claim file with notes, evaluations and decision making process
Coverage, Liability and Evaluation
- Determines and explains minimum coverage limits in complex claims involving single or multiple claimants
- Sets initial reserve, updates reserve, documents rationale and claim summary notes
- Obtains photos and/or conducts scene investigation
- Takes recorded statements from claimants, insureds, witnesses, medical providers, etc., conducts investigations into complex auto accidents, determines liability and prepares summaries
- Evaluates and determines potential use of experts; reviews reports and participates in selecting the expert
- Determines claim value
- Reviews file to identify complex potential legal issues
Negotiation and Settlement Guidance
- Negotiates and settles claims in accordance with business unit best practices
- Reviews medical reports in preparation for claims settlement evaluation
Other Projects and Responsibilities
- May participate in one or more complex special assignments
- May serve as a committee team lead for medium-sized projects or as a committee team member on large projects
- May serve as a subrogation or arbitration panelist
- May serve as an agent advocate
- Participates in targeted reviews
- May participate in oversight activities
- Researches, responds to, or participates in Department of Insurance complaints or investigations
- May assist or participate in Telephone Alert Conferences regarding complex claims referred to Home Office
- Assists in reviewing files and making recommendations to refer files to Home Office for escalation
- Assists in researching or responding to or resolving complex compliance issues
- Bachelors degree in related field preferred or equivalent experience
- Ability to interact effectively, and coach others on interacting effectively, with internal or external customers and act with empathy
- Applies broad knowledge of insurance policy, coverage, and regulation
- Applies broad knowledge of claim processes, policies, procedures, claim systems, coverage, liability, damage estimating, and/or settlement, and adherence to applicable legal compliance standards
- Applies broad industry knowledge to discipline practices, including best practices, to support the business unit
- Applies broad knowledge of analytical procedures to reconcile, manipulate, and recognize patterns of data
- Applies broad knowledge of problem solving and preparation of reports for analysis
- Applies broad ability to leverage learned technical skills in support of team objectives
- Applies broad negotiation and/or arbitration skills
- Applies broad conflict management and problem resolution skills in managing internal and external customer relationships
- Applies broad problem solving skills to continuously improve business outcomes
- Applies broad knowledge of training facilitation and coaching skills
- Ability to investigate, evaluate, negotiate and settle complex claims
- Provides broad individual decision making within authority limits
- Has and maintains all appropriate licenses and registrations for the role per state requirements
The candidate(s) offered this position will be required to submit to a background investigation, which includes a drug screen.
Good Work. Good Life. Good Hands.
As a Fortune 100 company and industry leader, we provide a competitive salary but thats just the beginning. Our Total Rewards package also offers benefits like tuition assistance, medical and dental insurance, as well as a robust pension and 401(k). Plus, youll have access to a wide variety of programs to help you balance your work and personal life -- including a generous paid time off policy.For a full description of Allstates benefits, visit allstate.jobs/benefits/
Allstate generally does not sponsor individuals for employment-based visas for this position.
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