Primary Job Duties & Responsibilities
Handle 1st party Boiler & Machinery/Equipment Breakdown claims of low to moderate severity and complexity as assigned.
Investigate and evaluate all relevant facts to determine coverage, damages and liability of first-party property claims under a variety of policies.
Review and analyze policy conditions, provisions, exclusions and endorsements pertinent to a variety of property losses.
Review and analyze Reinsurance treaties, agreements, provisions, exclusions and applicable property forms that are appropriate to the various programs and losses.
Obtain and analyze leases, contracts, by-laws and other relevant documents which may have an impact on the adjustment of losses.
Work with customers and vendors to determine restoration options to mitigate loss.
Establish timely and accurate claim and expense reserves.
Determine settlement amounts based on independent judgment, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles.
Negotiate and convey claim settlements within authority limits to insureds.
Work closely with reinsurance business partners to achieve optimal claim resolution.
Write denial letters, Reservation of Rights and other complex correspondence to insureds.
Control damages through proper usage of cost containment tools.
Meet all quality standards and expectations as contained in the applicable Knowledge Guide.
Maintain an effective diary system and document claim file activities in accordance with established procedures.
Manage file inventory to ensure timely resolution of cases.
Handle files in compliance with state regulations, where applicable.
Provide excellent customer service to meet the needs of the insured, agent and all other internal and external customers.
Identify and refer claims with MCU exposure to the supervisor.
Identify and refer claims that may have valued added by an outside field inspection conducted by Risk Control or engineering consultants.
Determine cases that may have fraud potential and to refer claims to Special Investigations Unit.
Perform other duties as assigned.
In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
Job Specific & Technical Skills & Competencies
Excellent organization skills with ability to work independently.
Strong verbal and written communication skills.
Customer service orientation; empathy.
Demonstrated ownership attitude and customer centric response to all assigned tasks.
Solid analytical and decision making skills.
Working knowledge of Excel and Word Excellent negotiation skills.
Hardware and software skills to utilize and leverage claim and estimating technology.
This position is responsible for handling 1st party Boiler and Machinery/Equipment claim. The equipment related property losses include spoilage and business income loss. The majority of claims will have financial exposure of less than $25,000, but can involve higher exposure depending on loss type and nature of the damaged property. Occasionally handles claims with additional complexities related to unique equipment and/or damage issues.
As part of the hiring process, this position requires the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration.
This job does not manage others This job works under General Supervision: Incumbent independently performs a variety of duties, including potentially complex duties within established policy guidelines; responsible for a defined set of assignments (e.g. assigned customers, claims or other specified set of responsibilities); is expected to set priorities and meet specific goals and objectives of the function or unit. (Typically pertains to advanced/operational, senior professional, unit supervisor)
Education, Work Experience & Knowledge
Bachelor's Degree Preferred.
Property claim handling experience preferred.
Experience utilizing computer technology; such as Microsoft Office, e-mail, Web-enabled applications , and database software.
Prior hands-on mechanical/electrical experience a plus.
Multilingual (Spanish and Korean) proficiency a plus.
A minimum of one year property claim handling experience preferred.
Operates standard office equipment
Sitting (Can stand at will)
Use of Keyboards, Sporadic 10-Key
High School Diploma or GED required. A minimum of one year claim handling experience required
The Travelers Companies