Primary Job Duties & Responsibilities
Directly handles assigned severe claims. Provides quality customer service and ensures file quality and timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case.
Consults with Manager on use of Claim Coverage Counsel as needed. Directly investigate each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Interview witnesses and stakeholders; take necessary statements, as strategically appropriate.
Completes outside investigation as needed per case specifics. Actively engages in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts. Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation.
Maintains claim files and documents claim file activities in accordance with established procedures. Utilizes evaluation documentation tools in accordance with department guidelines. Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis.
Utilizes diary management system to ensure that all claims are handled timely. At required time intervals, evaluate liability and damages exposure. Establishes and maintains proper indemnity and expense reserves.
Recommends appropriate cases for discussion at roundtable. Attends and/or presents at roundtables/ authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expense. Actively and enthusiastically shares experience and knowledge of creative resolution techniques to improve the claim results of others.
Develops and employs creative resolution strategies. Promptly and properly disposition all claims within delegated authority. Negotiates disposition of claims with insureds and claimants or their legal representatives.
Recognizes and implements alternate means of resolution. Manages litigated claims. Develops litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers.
Applies litigation management through the selection of counsel, evaluation and direction of claim and litigation strategy. Tracks and controls legal expenses to assure cost-effective resolution. Effectively and efficiently manage both allocated and unallocated loss adjustment expenses.
Attends depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. Updates appropriate parties as needed, providing new facts. 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. Perform other duties as assigned.
Job Specific & Technical Skills & Competencies
Openness to the ideas and expertise of others actively solicits input and shares ideas. Strong negotiation and customer service skills.
Intermediate Demonstrated coaching, influence and persuasion skills.- Intermediate Strong written and verbal communication skills are required so as to understand, synthesize, interpret and convey, in a simplified manner, complex data and information to audiences with varying levels of expertise.- Intermediate Strong technology aptitude; ability to use business technology tools to effectively research, track, and communicate information.
Intermediate Attention to detail ensuring accuracy
Intermediate Job Specific Technical Competencies: Analytical Thinking
Intermediate Judgment/Decision Making
Intermediate Insurance Contract Knowledge
Intermediate Principles of Investigation
Intermediate Value Determination
Intermediate Settlement Techniques
Intermediate Legal Knowledge
Basic Medical Knowledge
Under general supervision, the position is responsible for investigating, evaluating, reserving, negotiating and resolving assigned General Liability related Bodily Injury and Property Damage claims. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, litigation management, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations.
Provides consulting and training resources, and serves as a contact and technical resource to the field and our business partners. This job does not manage staff. 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.
Education, Work Experience & Knowledge
Bachelor's Degree preferred. 3 years bodily injury liability claim handling and/or litigation experience. Skilled in coverage, contract interpretation, liability and damages analysis and has a thorough understanding of the litigation process, relevant case and statutory law and expert litigation management skills.
Extensive claim and/or legal experience and technical expertise to evaluate severe and complex claims. Able to make independent decisions on most assigned cases without involvement of supervisor. Thorough understanding of business line products, policy language, exclusions, ISO forms, and effective claims handling practices
High School Degree or GED required with a minimum of 2 years bodily injury litigation claim handling experience.
The Travelers Companies