General Liability Claims Representative

Job Type Full-time Description

The Claims Representative investigates, evaluates, and adjusts General and Automobile Liability claims. The Claims Representative must be qualified legally and technically to handle all claims competently. Claims generally consist of low to medium exposure, first and third-party automobile bodily injury, property damage, premises liability accidents, and product liability claims. 

The following statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of the person holding this position. Duties, responsibilities, and activities may change at any time with or without notice. 

 

PRINCIPAL DUTIES AND RESPONSIBILITIES

• Based on the area of responsibility, the employee shall be asked to perform all the following essential functions, and other duties as assigned:
• Investigate, analyze, and determine the extent of insurance provider’s liability concerning personal, casualty, or property loss or damages, and attempt to effect settlements with claimants.
• Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information. Calculate benefit payments and approve payment of claims within a certain monetary limit.

 Investigate claims

• Assess and estimate vehicle damage.
• Compile information through interviews.
• Evaluate customer records.
• Examine evidence to determine if it will support claims.
• Assist with business or managerial research.
• Follow contract, property, or insurance laws.
• Follow rules of evidence procedures in a legal setting.
• Search legal records.
• Interview, telephone, and/or correspond with claimants and witnesses 
• Gather physical evidence.
• Inspect properties to determine damages.
• Research property records. 

Evaluate Liability Exposure: 

• Review insurance applications.
• Review insurance policies to determine appropriate coverage.
• Obtain, review, and evaluate records; police, medical, etc.
• Recommend claim action. 
• Properly reserve for the claim.
• Adjust reserves as appropriate.
• Comply with accepted guidelines regarding reserving practice and authority levels.

Create & Maintain Records: 

• Maintain records, reports, and files which are primarily found on the SIMS and/or Renaissance Systems.
• Comply with all reporting  requirements and steps set out in the GHC Claims Handling Best Practices.
• Comply with regulatory requirements.
• Maintain all cases on an active diary on the CMIS pursuant to established Company criteria.
• Prepare timely reports for clients.
• Diary spoken or written information.

Litigation Management Support:

• Collect evidence to support contested claims in court.
• Keep clients advised.

Requirements

EDUCATION, EXPERIENCE, &   TRAINING

• Four-year college degree (preferred)
• At least five (5) years’ experience with insurance claims, self-insurance, pooled insurance, or Joint Powers Authorities (JPAs).
• Excellent written and verbal communication skills.
• At least two (2) years’ experience of Property Damage claims experience
• Public Entity experience (preferred)

KNOWLEDGE, SKILLS, & ABILITIES

• Ability to work guided by ethics and integrity.
• Ability to understand relevant legal documents associated with a claim.
• Ability and desire to provide exceptional service to the insureds and clients.
• Ability to understand and follow all regulatory requirements.
• Ability to build a collaborative relationship with clients and co-workers.
• Ability to multi-task and change directions quickly.
• Ability to produce accurate, thorough work within the allotted time.
• Ability to follow directions.
• Ability to problem solving.
• An intermediate to advanced knowledge of Microsoft Office Suite (365).
• Dedication to performing all required tasks and duties while maintaining the highest level of integrity, providing exceptional service, and maintaining healthy relationships with clients and coworkers.
• Ability and willingness to follow George Hills’ Company Claims Handling Best Practices, reserving practices, and authority levels.
• Ability to make sound discretionary decisions as necessary, including but not limited to establishing appropriate reserves, counsel selection, settlement decisions, etc.
• Ability to establish billing goals.
• Ability to repeatedly deliver Client satisfaction.
• Ability to proactively handle and manage assigned cases in keeping with client and Company expectations.
• Ability to communicate, meet, and deal tactfully with coworkers.
• Ability to function as part of a team.
• Ability to adapt to change as well as provide suggestions for change when needed.
• Ability to meet time deadlines.
• Ability to work effectively in a fast-paced office environment.

 WORKING CONDITIONS & PHYSICAL REQUIREMENTS

• Work is normally performed in a climate-controlled office environment.
• Sit for long periods of time.
• Normal physical strength and ability to lift and maneuver routine office materials, equipment, and tools.
• Lift and/or move boxes up to 25 lbs.
• Mental effort: Normal concentration/intensity; normal memory, taking into consideration the amount and type of information; normal complexity of   decision making; normal time pressure of decision making.
• Normal hand, finger, and eye coordination and dexterity. 
• Normal ability to stoop, kneel, and crouch.
• Normal physical mobility, which includes movement from place-to-place on the job  taking distance and speed into account.

 ADDITIONAL REQUIREMENTS

• Travel, if any, should be infrequent.
• Working nights, weekends, or holidays may be required/necessary.
• The above job description is intended to represent only the key areas of responsibilities; specific position assignments will vary depending on the business needs of the department.

I have received, reviewed, and fully understand the job description above. I understand that I am responsible for the satisfactory execution of the essential functions described therein.

This document is not to be construed as an employment contract, but as an acknowledgement of the duties of the job and expectation of successful execution of the same.

Salary Description $65,000 - $72,500