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Manages, investigates, and resolves claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed authority levels. Recommends ultimate resolution on assigned cases in excess of their authority to local claims management.
Litigation handling experience in both General Liability and Casualty files.
Evaluate insurance coverage based on claim report, the insurance policy and applicable statutes and case law to determine if a claim can be accepted as being within coverage.
Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action. Responds to various written and telephone inquiries including status reports.
Present file materials for authority and roundtables.
Knowledge of both property and casualty adjusting software and able to review estimates for accuracy.
Comply with all statutory and regulatory requirements of all applicable jurisdictions.
Set and revise case reserves in accordance to the reserving policy.
Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation.
Accountable for security of financial processing of claims, as well as security information contained in claims files.
The capabilities, skills and knowledge required is normally acquired through a bachelor’s degree and at least 7+ years of directly related experience.
Strong written and oral communication skills required as well as strong interpersonal, analytical, investigative, and negotiation skills.
In-depth knowledge of multi-jurisdictional claims handling issues
Candidates must have, or be able to promptly obtain a Texas Independent Adjuster License
Advanced studies or insurance designation preferred