Western Reserve Group

Claims Specialist

• Investigates claims to determine cause, determines scope and amount of loss, verifies coverage and recommends ultimate resolution on assigned cases.
• Ability to accurately and independently interpret policies on all lines of business (Personal, Commercial & Farm).
• Promptly and accurately document all developments in claim file.
• Prepares accurate, clear, thorough, and concise notes or correspondence on conclusions and recommendations.
• Resolves claims within authority or subsequent Home Office approval.
• Identifies potential suspicious claims or possible third-party subrogation.
• Accountable for security of financial processing of claims, as well as security information contained in claims files.
• Ensures accurate reserves and adjusts as warranted.
• Recommends reserve increases on cases in excess of authority.
• May be necessary to prepare for and may attend trials, settlement conferences, and policyholder meetings.
• Present company position on coverage and disposition issues.
• Confers directly with policyholders on coverage and resolution issues pursuant to Home Office instructions.
• Analyzes assigned claims and plans for their investigation, may participate in training programs, conferences and departmental and intra-departmental meetings.
• May communicate with excess carriers and reinsures on case status and development.
• Perform onsite and virtual inspection of damages to resolve coverage and damage issues to including preparing complete estimates of repair for the covered damages.
• May work with contractors, building consultants or independent adjusters in the estimation process, as directed by Home Office.
• Proficient in writing estimates for building repairs.
• Manages claims for business interruption and proactively manages the period of restoration.
• Mentor Claim Representatives and Senior Claim Representatives upon request.
• Maintain continuing education.

Property Claims Specialist – Field