To monitor and direct the adjustment of claims by staff and independent Claim Representatives on claims with the assigned authority. This includes initial directions, coverage analysis, review of work product and general technical expertise as required based on the complexity of the claim, and the experience of the Claim Representative. In addition, the Claims Supervisor assists in interviewing applicants and executes disciplinary actions when necessary. Monitor and direct experts and attorneys as required based on the complexity of the loss and/or legal proceedings.
Assist set up unit in review of new claim reports and assign to appropriate claim rep with handling instructions.
Review reports and enclosures from claim reps as well as other mail directed to claims files. Analyze investigative material for exposure, coverage and damages to determine reserves and settlement values. Follow consistent reserve practices with a slightly pessimistic attitude to achieve the company guideline of overall reserve redundancy of 5 -10%. Maintain contact with regional claim manager, home office claims personnel and counsel as necessary. Provide direction, control and guidance to claim reps in the investigation and conclusion of claims. Be constantly aware of the expense factor in claims handling; whether by company representative, independent or defense counsel, in order to achieve company standards.
Deal directly with insured, claimants or counsel in settling losses.
Receive, evaluate and assign to counsel suits commenced against insureds or the company. Provide guidance to counsel as the discovery is underway. Coordinate any additional investigation required.
Maintain records of performance for Claims Representatives. Consult with Regional Branch Claim Manager on performance reviews. Personally go through the review with each employee. Provide information on salary review.
See that forms are filed (e.g. Index, PILR, Reinsurance, Reserve Notification, Risk Evaluation, State form filings and DCI).
Maintain relations with underwriters, auditors, marketing and agents operating within the territory.
Perform other job duties as assigned.
Three to five years total experience in claims to function properly in position. Prefer minimum of three years field experience. Four year college degree preferred plus AIC or SCLA or Legal Principles or CCLA and PCLA of the AEL series. Must possess general working knowledge of applicable law, policy coverage and damage evaluation procedures. Possess knowledge of vehicle repair, building construction, medical terminology, bodily injury analysis and value. Ability to use and teach negotiation skills. Have the capacity and ability to deal directly with people under adverse conditions. Be able to assess the action and skill required to investigate and properly handle new losses and select the best person to handle. Understand the fundamental basics of litigation and have the ability to deal effectively with attorneys. Must understand and work with various personality traits and provide motivations and inspirations to those for whom responsible.
GreatInsuranceRecruiters.com - 17 months ago