Claims Specialist

• To analyze Auto Bodily Injury Litigation claims on behalf of our valued clients to determine benefits due.
• Ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Auto & Bodily Injury Litigation Claims Examiner – Commercial Auto

• Investigating, evaluating, and negotiating general and auto liability claims.
• Conducting thorough investigations of coverage, liability, and damages.
• Communicating effectively with internal and external customers on claims issues.
• Maintaining and managing a diary system to manage claims inventory.
• Preparing Large Loss reports and maintaining ongoing claim updates.

Claims Analyst IV – Auto and GL

• Provides quality investigation and analysis to adjust claims of medium complexity/severity, including litigated files, to proper resolution
• Promotes the success of the organization through development of relationships with agencies, policyholders, and employees
• Collaborate and communicate with agents, policyholders, and internal stakeholders on claims of medium complexity/severity and book of business
• Investigate losses, identify coverage, evaluate liability and damages, review and analyze documents and legal pleadings
• Develop plan of action to proactively conclude claims, timely evaluate damages, engage other parties in negotiations and settle claims pursuant to guidelines
• Establish and maintain proper reserves for each claim to accurately reflect the financial exposure
• Determine need for, identify and engage external resources as needed to execute proper resolutions while monitoring and controlling costs
• Collaborate with internal partners to address contractual indemnifications and/or additional insured coverage issues
• Collaborate with counsel to manage litigated claims
• Review and interpret commercial insurance policies and accordingly communicate coverage issues verbally and in writing

Senior Auto & General Liability Claims Adjuster

• This position will be accountable for successfully investigating, reserving, assigning and settling first party property losses while delivering superior customer service.
• The ideal candidate will operate in the full file model and handle all claims by selecting the proper estimating resource to adjudicate the claim.
• Ensure quality standards are met with vendors utilized to adjudicate the claim.
• Claim File Management: Handle claim files in a manner consistent with Claim quality standards and goals.
• Negotiate skillfully in challenging situations with internal and external groups.
• Make independent business decisions to move claims forward as needed.
• Consistently provide high-quality customer service Meet or exceed expectations and requirements of internal and external customers.
• Properly assess the exposure of assigned claims.
• Utilize organization and communication skills to effectively resolve assignments, manage claim deadlines, and appropriately manage vendors.
• Develop technical and jurisdictional expertise, including knowledge of independent adjusters, contractors, vendors, etc.
• Set appropriate and timely file reserves.
• Identify and properly manage subrogation, salvage and other recovery opportunities.
• Identify fraud indicators and initiate investigation.
• Always demonstrate professionalism and establish credibility when interacting with customers; personally enhance The Hartford’s reputation in the marketplace.

Property Claims Adjuster

• Provide prompt, courteous and high-quality customer service to all policyholders and claimants by answering customer calls and resolving customer requests
• Gather necessary information from customers to initiate the claim and determine the appropriate course of action
• Manage an inventory of claims, establish initial reserves for all potential exposures, and adjust as appropriate throughout the claim
• Coordinate the repair, if necessary, for the property damage
• Recognize requirements for potential escalation should the loss no longer meet criteria for your handling
• Communicate and coordinate with involved parties regarding negotiations and settlement
• Provide input for continuous development best practices, and process improvements

Auto Property Damage Claims Adjuster

• Responsible for working with repair facilities to validate, adjudicate, and approve payment for diagnostics and repair recommendations for pre-sale repairs as well as customer vehicles under warranty.
• Properly adjudicates claims within approval limit and in accordance with department & industry standards.
• Accurately notates all actions taken and interactions with shops and customers within internal systems ensuring proper documentation of interactions.
• Effectively navigates department resources in order ensure adherence to department process flows and policies.
• Manages list of assigned pending claims and provides timely follow up with repair facilities to decision claims.
• Other duties as assigned.

Mechanical Claims Adjuster

• Handle and analyze general liability claims under general supervision
• Ensure ongoing adjudication of claims within company standards and best practices
• Analyze and process property damage claims with proactive handling
• Identify coverage issues and prepare comprehensive coverage letters
• Maintain claim files timely and properly documented

Claims Specialist III, Auto & General Liability

• Handle commercial auto claims with a predominant focus on resolving the material damage components of the claim
• Collaborate proactively with agents, policyholders, and internal stakeholders on claims and book of business as needed
• Investigate losses, identify coverage, evaluate liability and damages
• Develop plan of action to proactively conclude claims, engage other parties in negotiations and settle claims pursuant to guidelines
• Establish and maintain proper reserves for each claim to accurately reflect the financial exposure
• Review and interpret commercial insurance policies and communicate coverage issues verbally and in writing

Senior Auto Physical Damage Claims Representative

• Investigate and resolve commercial auto liability and physical damage claims related to trucking
• Review policy language to determine coverage and consult with coverage counsel as needed
• Manage a caseload of moderate to high complexity claims, including higher exposure files
• Communicate with insureds, claimants, attorneys, repair facilities, and law enforcement to gather information
• Work with defense counsel and vendors on litigated claims and recovery efforts
• Handle claims in accordance with company guidelines and regulatory requirements
• Participate in file reviews, team meetings, and training

Senior Trucking Liability Claims Adjuster, JD Required

• Adjusts and resolves low to moderate professional liability claims that include litigated matters
• Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities
• Heavy customer facing role. Must have confident communication skills. Communicates effectively to resolve matters directly with claimants, and or claimant attorneys
• With minimal supervision, drafts coverage letters, including reservation of rights and denial letters
• Reviews and analyzes claims in order to determine appropriate and timely reserving per Hiscox Claims Best Practices
• Identifies emerging exposures and claims trends
• Manages defense counsel as necessary in defending litigated matters
• Identifies suspected fraudulent claims and tracks with Special Investigations Unit
• Participates in Claims Projects, as needed

Senior Claims Examiner – MPL

• Handle claims across all sub-classes of NA Aerospace, focusing on general aviation aircraft damage and liability claims.
• Identify loss trends and risk management opportunities.
• Provide feedback to internal stakeholders.
• Proactively manage and adjust Aerospace claims.
• Effectively manage vendors, including attorneys and experts.

Claims Specialist – Aviation

Bilingual Auto Property Damage Claims Adjuster

• Researching claims — auditing them for accuracy, compliance, and correct payment
• Managing escalated and complex claims issues
• Reviewing emails for encounters, outside vendors, and special projects
• Creating reports to track trends and quality opportunities
• Supporting mass adjustment efforts
• Acting as a go-to subject matter expert for tricky claim questions

Senior Claims Examiner

• Investigate, analyze, and determine the extent of liability concerning first party homeowner property losses and damages.
• Effectively communicate and negotiate with policyholders, agents, public adjusters, attorneys, and service providers via phone, email, and internal systems to accurately document claim details.
• Successfully manage a pending claim load at varying stages of the claims process.
• Interpret and apply the details of an insurance policy to ensure the accuracy of payments and claims declinations.
• Interpret and apply computer generated loss estimates, engineer’s reports, and construction terminology.
• Update and maintain comprehensive claim handling notations in our electronic claims management system and other related applications.
• Mentor our mid and associate level claims representatives.

Complex Claims Representative

• Handles healthcare malpractice/negligence claims including analyzing coverage and communicating coverage positions
• Conducts, coordinates, and directs investigation into loss facts and extent of damages
• Confirms coverage of claims by reviewing policies and documents submitted in support of claims
• Drafts coverage position letters
• Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure
• Handles claims in all jurisdictions
• Handles litigated and non-litigated bodily injury claims with values up to $450,000 in all jurisdictions
• Represents Markel in mediations
• Monitors trial, as required
• Sets reserves within authority or makes recommendations concerning reserve changes to manager

Senior Claims Examiner, Medical and Healthcare Claims

• To process low level general liability & bodily injury claims to determine benefits due.
• Ensure ongoing adjudication of claims within company standards and industry best practices.
• Identify subrogation of claims and negotiate settlements with general supervision.
• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Liability Claims Representative – GL, BI Experience, License Required

• Examining and appropriately interpreting insureds’ policies, forms in force, and other records to determine coverage and extent of the company’s exposure and policy limitations
• Applying knowledge of multiple state statutes, including the insurance code of ethics, rules, regulations, and guidelines
• Desk reviewing, drafting, adjusting, and approving estimates of damage and loss amounts for structural damages, mitigation, remediation, etc
• Using varying methods of investigation, including taking recorded statements, consulting with experts, identifying property damage, and reviewing documentation
• Keeping active communication and working with customers, their representatives, contractors, and experts throughout the Claims process from first notice of the claim through repair completion
• Working with public adjusters and attorneys that may represent the insured(s) and responding to all notices and letters in accordance with state guidelines

Senior Claims Adjuster, Large Loss

• Investigate, analyze, and determine the extent of liability concerning first party homeowner property large losses and damages of $100K+.
• Negotiate settlements and make payments within scope of authority, settling claims timely, and in the most cost-effective manner.
• Effectively communicate with policyholders, agents, and service providers via phone, email, and internal systems to accurately document claim details.
• Effectively manage loss and expense reserves to ensure accurate and timely reserving practices on all large loss claim exposures.
• Create and maintain comprehensive claim handling documentation in the electronic claims management system and related applications including the completion and escalation of Large Loss Reports (LLR’s).
• Ability to successfully manage a pending claim volume at varying stages in the claims process.
• Interpret and apply the details of an insurance policy to ensure the accuracy of payments and claims declinations.
• Ability to understand, computer generated loss estimates and construction terminology.
• Update and maintain comprehensive claim handling notations in our electronic claims management system and other related applications.

Claims Specialist – Large Loss

• Reviewing and processing fraud‑related claims, primarily involving check transactions
• Ensuring all required documentation is received
• Evaluating claims to determine whether they should be honored or denied based on applicable criteria
• Taking appropriate account actions
• Debiting customer accounts or general ledger accounts when applicable
• Locating and tracking available funds
• Partnering with internal teams to support claim resolution and fund recovery
• Ongoing communication with internal stakeholders is required to coordinate claim decisions, account activity, and fund movement.

Claims Processor

• The Senior Claims Examiner adjudicates assigned claims within given authority and provides operational support to the claims team.
• Adjusts and resolves moderate to complex claims that includes all phases of litigation
• Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities
• With minimal supervision, drafts coverage letters, including reservation of rights and denial letters
• Reviews and analyses claim documentation and legal filings to set timely and accurate reserves and notify the manager if upward segmentation is needed
• Identifies emerging exposures and claims trends
• Drives litigation best practices to manage deployment and utilization of defense counsel
• Identifies suspected fraudulent claims and tracks with special investigations unit
• Participates in Claims Projects as needed

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Senior Claims Examiner

Complex Claims Representative

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