George Hills

Claims Specialist

• Conduct an initial investigation of the claim.
• Verify and enter data into the claims systems.
• Research and gather evidence. Obtain, review, and evaluate records, police, medical, etc.
• Correspond with or interview medical specialists, agents, witnesses, or claimants for accuracy and consistency with the claim as reported.
• Investigate, analyze, and determine the extent of the insurance provider's liability concerning personal, casualty, or property loss or damages, and attempt to settle with claimants.
• Comply with accepted guidelines regarding reserving practice and authority levels while properly setting the reserve and adjusting as appropriate.
• Examine, process, calculate, and pay claims ensuring filings, documentation, and reports, etc.
• Prepare timely reports for clients.

Claims Processor

• Investigate, analyze, and determine the extent of the insurance provider's liability concerning personal, casualty, auto or property loss or damages, and attempt to settle with claimants.
• Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information.
• Calculate and approve payment of claims within a certain monetary limit.
• Investigate claims:
• Assess and estimate vehicle or property damage.
• Compile information through interviews.
• Evaluate customer records.
• Examine evidence to determine if it will support claims.
• Follow contract, property, or insurance laws.
• Follow rules of evidence procedures in legal setting.
• Gather physical evidence.
• Inspect property to determine damages.
• Research property records.
• Conduct court searches.
• Interview claimants or witnesses.
• 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 reserve as appropriate.
• Comply with accepted guidelines regarding reserving practice and authority levels.
• Create and maintain records:
• Maintain records, reports, and files in our claims system.
• Maintain all cases on an active diary in our claims system pursuant to established GHC criteria.
• Assist in the preparation of timely reports to clients.
• Comply with all reporting requirements/steps set out in the GHC Claims Handling Best Practices guide.
• Comply with regulatory requirements.
• Diary spoken or written information.
• Litigation management support:
• Collect evidence to support contested claims in court.
• Keep clients advised.
• Other duties as assigned.

Claims Processor

Claims Representative