To review and analyze bodily injury claim files referred to litigation in order to determine potential exposures, identify cases that should be recommended for settlement, and develop strategic plans with defense counsel to resolve litigated claims in an efficient, cost-effective, quality manner.
Essential Job Results:
% of Time
Results Expected and Duties Performed
Monitors severity and expenditures by reviewing files to determine potential exposures; identifying impediments/extra-contractual obligations; analyzing cost effectiveness of litigation versus settlement; collaborating with defense counsel on the claim handling strategy, roles and responsibilities, and the budget(s).
Ensures legal compliance by accurately documenting findings and recommendations; handling litigated file according to established guidelines and procedures within specified timelines; attending mediations and trials.
Maintains workflow by corresponding with claimants, insureds and attorneys; assigning appropriate files to defense counsel; directing and monitoring cases assigned to defense counsel; reconciling invoices for billed Defense Services.
Maintains quality service by making timely contact and informing all relevant parties of case status; proactively communicating key personnel in other Departments.
Required behaviors for all positions :
- Communicate with co-workers, management customers, vendors, and others in a courteous and professional manner
- Conform with and abide by all Company codes, regulations, policies, values, work procedures and instructions
- Regular attendance
Education : Bachelor’s degree or equivalent (with two year’s work experience within field of major, is preferred).
Experience : Minimum 5 years bodily injury claims adjusting experience in the auto insurance industry with at least 2 years litigation experience. Full understanding of auto claims investigations and claims processing. Knowledge of automobile damage, mechanics of bodily injury, medical terminology, settlement negotiations and insurance case law.
Prior experience interpreting policy language and state statutes is required.
Prior experience in reviewing and analyzing bodily injury claim files referred to litigation in order to determine potential exposures, identify cases that should be recommended for settlement, and developing strategic plans with defense counsel to resolve litigated claims in an efficient, cost-effective, quality manner.
Ideal candidate will have a proven track record of making sound coverage and liability decisions based on facts presented by customers and/or through additional fact gathering and investigations.
Experience in handling moderate to severe “attorney represented” injury claims is required.
Skills and Abilities : Excellent verbal and written communications skills. General office skills and basic math. Ability to effectively manage own time and coordinate various tasks simultaneously. Effective negotiating skills. Ability to remain calm and professional when speaking with difficult customers. Ability to use logic and reasoning to identify approaches and solutions to problems. Ability to quickly build rapport and successfully effect settlements.
Other : Bilingual (English/Spanish) preferred.
Office Equipment and Software : Computer, phone, printer, calculator, copier and fax. MS Outlook, MS Word, MS Excel, Internet, AS400, Image Right and Claims Manager, and Allegient System.
Decision Making : Prior experience in presenting investigative findings of claim files along with strategic suggestions to a formal review board consisting of senior leaders, such as Senior Vice President. Strong ability to skillfully articulate the legal options as discussed and collaborated with defense counsel. Strong ability to set priorities and comply with Standard Operating Procedures, and Litigation Handling Guidelines.
Interpersonal Communication : Daily interaction with attorneys and insureds, claim adjusters, co-workers and key personnel in other Departments.
Compensation : Competitive salary based on experience. Excellent benefits package: medical, dental, vision insurance, life insurance, short term and long term disability insurance, 401K, Paid Vacation and Holidays. EOE.