Purpose: Investigate, evaluate and resolve claims of moderate complexity within established claim guidelines set forth by the Agribusiness Claim Department. Supports the Claim Department mission of handling claims in a timely, cost efficient manner while adhering to company claim compliance standards.
Essential Job Duties and Responsibilities:
Investigates and evaluates moderately complex claims by analyzing facts gathered during the investigation stage to determine application of coverage, liability, compensability, damages and recovery potential.
Adheres to claim procedural guidelines established for the Agribusiness Claim Department.
Sets and monitors appropriate reserves for pending claims within reserve authority.
Settles claims within delegated settlement authority.
Develops “action plans” to assist in resolving claim files to conclusion.
Maintains an effective diary system and adequate file documentation.
Manages Allocated Loss Adjustment Expense by directing vendors to perform only necessary task-specific assignments.
Maintains a working relationship between claims and the underwriting and marketing department.
May provide direction to lower level claims personnel.
Communicate with customers, vendors, medical providers, attorneys, agents, and other employees when necessary in the claims handling process.
Performs special projects and other job duties as assigned.
Knowledge, Skills, and Abilities
Ability to organize, prioritize and manage claim volume.
Ability to analyze issues, recommend solutions and make decisions with limited supervisory guidance.
Ability to articulate thoughts and issues clearly.
Ability to read and understand company procedure manuals and apply information to work tasks.
Ability to interpret and evaluate medical information.
Ability to comprehend and understand tort law statutes.
Ability to explain comparative negligence to insured’s and claimants.
Ability to apply depreciation on personal property claims.
Ability to organize and prioritize multiple tasks.
Ability to work well with people in a team environment.
Ability to effectively communicate and maintain business relationships with Company personnel, agents, outside resources, and customers.
Ability to learn and use the company terminology, processes and systems.
Knowledge of general office practices.
Ability to perform basic and complex mathematical calculations.
Ability to remain calm and professional.
Ability to work from oral and written communications.
Ability to work independently with limited supervision and follow assigned duties through to completion.
Ability to maintain confidentiality.
Ability to assist in other work-related areas as required.
Agri Bus Lead Adjuster
Ace Group - 2 years ago
The ACE Group is one of the world’s largest multiline property and casualty insurers. With operations in 53 countries, ACE provides...