Caradoc Townsend Mutual Insurance

Claims Specialist

• Investigate and evaluate claims across multiple lines of business (property, auto, and liability) to determine coverage, liability, damages, and appropriate settlement outcomes.
• Review claim documentation, policy wording, endorsements, and supporting evidence to confirm eligibility and compliance.
• Communicate with claimants, insureds, witnesses, brokers, and third parties to gather required information and explain claims processes and decisions.
• Negotiate settlements in accordance with policy provisions and delegated authority.
• Identify claims requiring escalation, litigation, or external expertise and provide recommendations to management and legal counsel.
• Participate in litigation support activities, including file preparation, consultations with counsel, and attendance at hearings where required.
• Handle Property, Liability, Accident Benefits and Bodily Injury claims as required, with focus on Accident Benefits claims, in support of overall multiline adjusting needs.
• Provide technical guidance and interpretation of policy coverage, exclusions, and conditions to ensure consistent claims handling.
• Review and analyze complex or escalated claims files to ensure adherence to internal standards, regulatory requirements, and best practices.
• Support consistency in reserving practices and submit claim liability information to actuarial or leadership teams as required.
• Assist in resolving claims-related complaints and appeals requiring advanced technical review.
• Act as a resource for staff on coverage interpretation and adjusting practices, including property, auto, and liability claims.
• Review claims processes, procedures, and workflows to identify opportunities for efficiency, accuracy, and quality improvement.
• Ensure claims handling aligns with company policies, procedures, and applicable legislation and regulatory standards.
• Prepare reports and analyze claims data to support monitoring, quality assurance, and management decision-making.
• Contribute to training initiatives, documentation, and knowledge sharing related to complex claims handling and policy interpretation.

• Investigate and evaluate claims across multiple lines of business (property, auto, and liability)
• Review claim documentation, policy wording, endorsements, and supporting evidence to confirm eligibility and compliance
• Communicate with claimants, insureds, witnesses, brokers, and third parties to gather required information and explain claims processes and decisions
• Negotiate settlements in accordance with policy provisions and delegated authority
• Identify claims requiring escalation, litigation, or external expertise and provide recommendations to management and legal counsel
• Participate in litigation support activities, including file preparation, consultations with counsel, and attendance at hearings where required
• Handle Property, Liability, Accident Benefits and Bodily Injury claims as required
• Provide technical guidance and interpretation of policy coverage, exclusions, and conditions to ensure consistent claims handling
• Review and analyze complex or escalated claims files to ensure adherence to internal standards, regulatory requirements, and best practices
• Support consistency in reserving practices and submit claim liability information to actuarial or leadership teams as required
• Assist in resolving claims-related complaints and appeals requiring advanced technical review
• Act as a resource for staff on coverage interpretation and adjusting practices, including property, auto, and liability claims
• Review claims processes, procedures, and workflows to identify opportunities for efficiency, accuracy, and quality improvement
• Ensure claims handling aligns with company policies, procedures, and applicable legislation and regulatory standards
• Prepare reports and analyze claims data to support monitoring, quality assurance, and management decision-making
• Contribute to training initiatives, documentation, and knowledge sharing related to complex claims handling and policy interpretation