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Years of Experience
Date Last Verified
ProfileProfessional Associate - Claims Duties: Under close supervision, receives 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. 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 extent 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.
Qualification and Experience
REQUIREMENTS: JD Degree or Bachelor’s degree or Master’s degree or equivalent experience. Knowledge of insurance industry. Basic knowledge of claims handling concepts, practices, and procedures. Basic Microsoft Word, Excel, and Outlook. Ability and willingness to travel and relocate Analytical, Detailed Oriented. Customer focus – responsive with an appropriate sense of urgency. 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. Strong Negotiation and Presentation Skills. Ability to work collaboratively, independently and as part of a team. Ability to Multitask. Ability to adjust and adapt in an ever changing environment. Technically proficient. Committed to high standards of behavior and performance.
Job Number: 313726