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Esis Claims Representative

Expired Job

Chubb Detroit , MI 48222

Posted 4 months ago

The Claim Representative, under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably and within established best practices guidelines.

MAJOR DUTIES & RESPONSIBILITIES:

Duties may include but are not limited to:

  • Receive assignments.

  • Reviews claim and policy information to provide background for investigation and may determine the extent of the policy's obligation to the insured depending on the line of business.

  • Contacts, interviews and obtains statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.

  • Depending on line of business may inspect and appraise damage for property losses or arranges for such appraisal.

  • Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extend of the company's obligation to the insured under the policy contract.

  • Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc.

  • Sets reserves within authority limits and recommends reserve changes to Team Leader.

  • Reviews progress and status of claims with Team Leader and discusses problems and suggested remedial actions.

  • Prepares and submits to Team Leader unusual or possible undesirable exposures. Assists Team Leader in developing methods and improvements for handling claims.

  • Settles claims promptly and equitably.

  • Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.

  • Informs claimants, insureds/customers or attorney of denial of claim when applicable.

  • May assist Team Leader and company attorneys in preparing cases for trial by arranging for attendance of witnesses and taking statements. Continues efforts to settle claims before trial.

  • Refers claims to subrogation as appropriate. May arrange for salvage disposition or other recovery proceedings as necessary by line of business.

  • May participate in claim file reviews and audits with customer/insured and broker. Administers benefits timely and appropriately. Maintains control of claim's resolution process to minimize current exposure and future risks

  • Establishes and maintains strong customer relations

Depending on line of business, other duties may include:

  • Maintaining system logs

  • Investigating compensability and benefit entitlement

  • Reviewing and approving medical bill payments

  • Managing vocational rehabilitation

DESIRED QUALIFICATIONS:

  • 2-5 years' experience handling claims in a relevant line of business.

  • Basic knowledge of claims handling and familiarity with claims terminologies

  • Effective negotiation skills

  • Strong communication and interpersonal skills to be capable of dealing with claimants, customers, insureds, brokers, attorneys etc. in a positive manner concerning losses.

  • Ability to self-motivate and work independently

  • Knowledge of company products, services, coverage's and policy limits, along with awareness of the company's claims best practices

  • Knowledge of applicable state and local laws

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Esis Claims Representative

Expired Job

Chubb