Claims Specialist

• 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.

Workers Compensation Claims Examiner – CT, MA, NH, RI, VT Jurisdictional Knowledge

• Analyzing liability claim submissions for potential coverage
• Setting adequate case reserves
• Promptly and professionally responding to inquiries from customers and their brokers
• Proactively driving early resolution of claims arising from the Cyber, Tech PL, Media and/or Crime professional liability lines of business
• Reviewing and analyzing claim documentation and legal filings
• Drafting coverage analyses for tech E&O, first and third party cyber claims
• Strategizing and maximizing early resolution opportunities
• Monitoring litigation and managing local defense and breach counsel
• Attending mediations and/or settlement conferences, either in person or by phone as appropriate
• Managing and tracking third-party vendor and service provider spend
• Continually assessing exposures and adequacy of claim reserves

Complex Claims Specialist – Cyber Tech E&O, Media & Crime

• 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

• Manages complex primary and excess financial lines claims under claims‑made policies
• Applies strong technical expertise and sound judgment to evaluate, manage, and resolve claims in accordance with company standards and regulatory requirements
• Plan, recommend, reserve, and execute file strategies including investigation, valuation, disposition, and settlement of assigned claims
• Draft and issue timely reservation of rights letters on all files and independently draft denials for management review
• Properly assesses the exposure of assigned claims
• Establish priorities and communicate the status of assignments
• Maintain current knowledge of claim loss cost management initiatives
• Obtain first-hand customer information and use it for improvements in products and services

Senior Claims Analyst – Healthcare, Lawyers Professional Liability

• Analyze Lost-Time Workers Compensation claims on behalf of clients to determine benefits due.
• Ensure ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Workers Compensation Claims Adjuster – CT, MA Jurisdictions, CT License

• Investigates origin and cause of high exposure claims by contacting the appropriate parties including insureds, claimants, agents, attorneys, contractors, experts, special investigation unit, other adjusters, public personnel, etc.
• Checks for prior claims and recognizes environmental exposures.
• Participates in High Damage Reviews (HDR) to address coverage issues and exposure.
• Handles claims on a good faith basis.
• Handles both 1st party and 3rd party claims under multiple policy types and numerous endorsements.
• Conducts on-site inspections when needed, evaluates damages and handles claim negotiations with insureds, claimants, attorneys, public adjusters.
• Interprets and determines policies, leases, by-laws, declarations, articles, and contract coverages and applies to all parties for assigned losses.
• Proactively provides all parties with claim process and status as appropriate; answers questions or redirects to other areas.
• Serves as a mentor and subject matter expert for less experienced adjusters.

Large Loss Property Field Claims Adjuster

• Conducting investigations and analyzing and evaluating the information learned
• Making coverage determinations and communicating written position(s) to insureds and other required parties
• Within prescribed authority levels, setting appropriate expense and indemnity reserves and monitoring on a regular basis for any needed adjustment
• Presenting cases to management for expense or indemnity reserve authority above established authority levels
• Developing and implementing resolution strategies to achieve high quality outcomes
• Proactively managing litigation and counsel, inclusive of litigation planning and execution, budgeting and bill review
• Attending trials and mediations as necessary
• Contributing to broader claim and enterprise goals by participating in audits, projects and product development initiatives
• Preparing comprehensive reports and delivering presentations to senior claim leadership on case developments, policy issues, industry trends, etc.
• Providing support to field offices to assist field personnel with coverage and liability analysis, time limit demands, extra contractual exposure evaluations and other issues of complexity
• Work with business partners to evaluate and address claim trends and developments
• Address inquiries from agents and policyholders, providing superior customer service

Personal and Advertising Injury Liability Claims Specialist

• Manage complex primary and excess financial lines claims under claims-made policies
• Plan, recommend, reserve, and execute file strategies including investigation, valuation, and disposition of assigned claims
• Appropriately escalate matters to Team Lead/management per escalation protocols
• Maintain current knowledge of claim loss cost management initiatives
• Obtain first-hand customer information and utilize it for improvements in products and services
• Utilize verbal and numerical critical thinking skills to gather information and make sound decisions

Senior Claims Analyst – Allied Health Professional Liability

• Handling a caseload of complex, high exposure, auto and general liability claims throughout the claim’s life cycle
• Conducting investigations and analyzing and evaluating the information learned
• Making coverage determinations and communicating written position(s) to insureds and other required parties
• Setting appropriate expense and indemnity reserves and monitoring on a regular basis for any needed adjustment
• Presenting cases to management for authority above established levels
• Developing and implementing resolution strategies to achieve high quality outcomes
• Proactively managing litigation and counsel, including planning and execution, budgeting and bill review
• Attending trials and mediations as necessary
• Contributing to broader claim and enterprise goals

Auto and General Liability Claims Specialist

• 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

• Responsible for the handling of high-severity primary Professional Lines claims from inception to resolution
• Adjusts to resolution the highest severity claims and drafts the most complex technical coverage analysis and letters required
• Acts as subject matter expert within the team
• Models gold standard for litigation best practices and file integrity
• Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and alternative dispute resolutions
• Identifies and provides potential solutions for emerging exposures and claims trends
• Identifies suspected fraudulent claims and tracks with special investigations unit
• Accurately documents claim files with all relevant correspondence and notes
• Mentors other team members, including providing formalized training, as needed

Senior Complex Claims Specialist, PL & Specialty Severity

• Adjusts and resolves complex mid to severity claims that include all phases of litigation
• With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters
• Reviews and provides analysis of claim documentation and legal filings
• Drives litigation best practices to lead defense strategy on litigated files
• Mentors team members
• Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions
• Identifies emerging exposures and claims trends
• Identifies suspected fraudulent claims and tracks with special investigations unit
• Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities

Complex Claims Specialist – MPL

• Conduct field based investigations by visiting policyholders’ homes to investigate property damage.
• Use claims handling software, a company car and laptop to determine claims related damage and write estimates in a paperless environment.
• Represents the Company from a public relations standpoint and must conduct oneself as a member of Management at all times.
• Use strong customer service skills to negotiate with policyholders to settle the claim.
• Investigates, confirms coverage, determines liability, establishes damages, reports status and negotiates the settlement of assigned cases (has authority to make payment of assigned claims within prescribed limits).
• Adjusts all types of claims.
• Inspects damaged property and vehicles, and determines claims related damage.
• Estimates the cost of repair or replacement of damaged or stolen property and vehicles.
• Determines and reports on subrogation potential.
• Initiates the sale of salvage vehicles, personal property, and miscellaneous salvage items.
• Reports theft, fraud, and arson losses as required to state and industry agencies.
• Performs most duties on an individual basis, and work has a direct bearing on Management results.
• Promotes safety at all times and complies with safety/ergonomic standards as outlined in relevant company published manuals.

Field Property Claims Adjuster

• 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

• Handle and investigate Defense Base Act claims within Federal jurisdiction
• Promote and demonstrate principles of ‘Treating Customers Fairly’ in claims handling
• Identify and review suspect/fraudulent claims
• Build effective relationships with internal stakeholders and external customers
• Support Team Managers and monitor market/industry practices in claims handling

Senior Claims Examiner

Workers Compensation Claims Examiner, CT, MA, NH, RI, VT Jurisdictions

• 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

• Handling an inventory of claims-made, large company, middle market, and small commercial EPL claims
• Conducting investigations and analyzing and evaluating the information learned
• Accurately analyzing and determining coverage, liability and damages based upon the facts of each claim
• Proactively managing caseload including evaluation of overall exposure and identification of potential financial impact to the policy
• Communicating written position(s) to insureds, management and other required parties
• Presenting cases to management for expense or indemnity reserve authority on appropriate files

Employment Practices Liability Claims Analyst

• Manage a book of pending claims through effective time management to ensure timely payments
• Process decisions on claims through claim management system (Promise 360) and/or new business application (Compass)
• Approve and deny claim payments within authorization limits
• Render decisions on disability extension requests and traumatic injury claims within authorization limits
• Obtain necessary information for claim decisions from various sources including, but not limited to, the Veterans Administration, branches of service, beneficiaries, attorneys, and police departments.
• Correspond with claimants, law department, underwriting, Casualty Assistance Officers, attorneys, the Veterans Administration, and other interested parties through the life of a claim
• Prioritize work to ensure meeting of performance standards
• Other duties as assigned

Claims Examiner

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Workers Compensation Claims Examiner – CT, MA, NH, RI, VT Jurisdictional Knowledge

Complex Claims Specialist – Cyber Tech E&O, Media & Crime

Property Claims Adjuster

Senior Claims Analyst – Healthcare, Lawyers Professional Liability

Workers Compensation Claims Adjuster – CT, MA Jurisdictions, CT License

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