Manager Complex Workers Compensation Claims
Crum & Forster Insurance Co - Orange, CA

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Summary:

A newly created position that will be responsible for supervising a unit comprised of Claim Specialists that handle the most complex claims in the department. This person will monitor claims trends and will report out on a regular basis on identified trends and action plans to address unfavorable trends to Senior Claims Management.

Responsibilities:

-Directs policies and procedures to ensure claims handling is consistent with Crum & Forster’s Claims Handling Best practices in addition to all legal and regulatory requirements.

-Participates with Regional Claims Management in the planning, processing and establishment of regional business objectives.

-Keeps claims management and underwriting fully aware of any trends or environmental factors that have or may have an impact on claims costs. Use industry publications, seminars, groups, and other sources to stay well informed of key developments.

-Reviews legal decisions to keep abreast of current case law and trends.

-Maintains an efficient claims staff to dispose of all claims promptly and fairly in accordance with applicable contract provisions, state laws and regulations, local conditions, and company policies.

-Identifies coverage issues and reviews all coverage evaluation letters.

-Follows all high exposure claims to ensure accurate reserving and sound case strategy.

-Approves case reserve recommendations, establish reserves and make recommendations on case reserves above authority levels; analyze and review on a continual basis, the reserve adequacy of claims handled within the Specialist unit.

-Provides guidance in the negotiations of claims and extend settlement authority t0 the Claims Specialist.

-Recruits, acquires, mentors and retains qualified staff.

-Establishes, implements, and monitors regional office claims objectives in conformance with company objectives.

-Provides excellent customer service to both external and internal customers.

Requirements:

-At least ten years in WC Claims Supervisory and/or Management position

-Strong verbal & written communication skills

-Experience with Microsoft Office and Lotus Notes software applications

-Bachelor’ Degree

Crum & Forster - 11 months ago - save job - block
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