Insurance

• Analyze and process bodily injury and third-party property damage claims by investigating and gathering information to determine the exposure on the claim; ensure proactive claims handling aimed at the prompt and cost-effective resolution of claims through well-developed action plans.
• Determine need for and direct independent adjusters to gather information to determine exposure on the claim and control their costs.
• Identify and evaluate coverage issues; prepare comprehensive coverage letters with supervisory review and analysis; retain and provide direction to coverage counsel when necessary.
• Assess liability and resolve claim within established evaluation.
• Maintain diaries and complete tasks within required timeframes as set forth by department guidelines; ensure claim files are timely and properly documented with clear and concise analysis on coverage, damages, reserves, and liability including an action plan for resolution.
• Process and pay invoices within a timely manner.
• Coordinate vendor referrals for additional investigation and/or litigation management.
• Calculate and assign timely and appropriate reserves; monitor reserve accuracy throughout the life of the claim.
• Refer case as appropriate to supervisor and management.
• Respond to requests or directions in a professional and timely manner.
• Attend arbitrations, mediations, settlement conference and trials.
• Successfully complete required State licensing examinations and continuing education requirement.
• Communicate with all internal business partners including underwriters to make sure underwriting is aware of large losses and industry trends.
• Partner with TPA Governance and Relationship Management to help TPA’s and Insureds comply with claim handling and reporting guidelines.
• Work with TPA Claims Financial to check the accuracy of TPA financials ensuring alignment with TTPO financials.

Commercial Claims Adjuster, TPA Oversight

Insurance Career Advisor

Insurance Consultant

Health Insurance Representative

Insurance Account Representative

Insurance Advisor