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Years of Experience
Date Last Verified
ProfileProfessional Associate – Claims Under close supervision, the candidate will receive assignments and 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. Contact, interview and obtain 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. Evaluate facts supplied by investigation to determine extent of liability of the insured, if any, and extent of the company’s obligation to the insured under the policy contract. Prepare reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc. Set reserves within authority limits and recommends reserve changes to Team Leader. Review progress and status of claims with Team Leader and discusses problems and suggested remedial actions. Prepare and submit to Team Leader unusual or possible undesirable exposures. Assist Team Leader in developing methods and improvements for handling claims. Settle claims promptly and equitably. Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims. Inform claimants, insureds/customers or attorney of denial of claim when applicable. JD or Bachelor’s degree or Master’s degree or equivalent experience required. Knowledge of insurance industry and basic knowledge of claims handling concepts, practices, and procedures required. Basic Microsoft Word, Excel, and Outlook required. Strong Communication Skills - including the ability to listen effectively; to confidently and diplomatically express opinions and voice concerns with other team members; and to present effective written communication to varied audiences. Excellent Interpersonal Skills: Ability to establish trust and effective working relationships with others on an external and internal basis.
Job Number: 314988