General Liability Claims Representative

Job Type Full-time Description

The Claims Representative investigates, evaluates, and adjusts General and Automobile Liability claims. Although assigned claims generally consist of low to medium exposure, first and third-party automobile bodily injury and property damage claims, as well as premises liability accidents, product liability claims, the claims adjuster must be qualified legally and technically to handle all claims competently.

The Claims Adjuster is a key employee, whose unplanned or prolonged absence would dramatically affect the Company.

The following statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of the person holding this position. Duties, responsibilities and activities may change at any time with or without notice.

PRINCIPAL DUTIES AND RESPONSIBILITIES

Based on the area of responsibility, the employee shall be asked to all of the following essential functions:

• Investigate, analyze, and determine the extent of insurance provider's liability concerning personal, casualty, or property loss or damages, and attempt to effect settlement 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.
• Assist with business or managerial research. 
• 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. 
• Search legal records Interviews, telephones, and or corresponds with claimant and 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 which are primarily found on the SIMS and/or Renaissance system.
• Maintain all cases on an active diary on the SIMS and/or Renaissance system pursuant to established Company criteria.
• Prepare timely reports to clients.
• Comply with all reporting requirements/steps set out in the GHC Procedure Manual.
• 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.

Requirements

 EDUCATION/EXPERIENCE/TRAINING  

• At least three  years’ experience with insurance claims, self-insurance, pooled insurance, or Joint Powers Authority.
• Excellent written and verbal communication skills.

C. KNOWLEDGE, SKILLS, AND ABILITIES

• Ability to work guided by ethics and integrity.
• Ability to understand relevant legal documents associated with a claim.
• Ability and desire to provide exceptional service to the insureds and client.
• Ability to understand and follow all regulatory requirements.
• Ability and willingness to follow George Hills’ Best Practices, reserving practices, and authority levels.
• Ability to make sound discretionary decisions as necessary including but not limited to establishing appropriate reserves, counsel selection, settlement decisions, etc.
• Ability to establish billing goals.
• Ability to repeatedly deliver Client satisfaction.
• Ability to proactively handle and manage assigned cases in keeping with client and Company expectations.
• Ability to build a collaborative relationship with clients and co-workers.
• Ability to multi-task and change directions quickly. 
• Ability to work effectively in a fast-paced office environment is essential.
• Ability to follow direction.
• Ability to problem solve.
• Ability to communicate, meet and deal tactfully with co-workers.
• Ability to function as part of a team.  
• Ability to adapt to change as well as provide suggestions for change when needed.
• Ability to meet time deadlines.
• Ability to produce accurate thorough work within the allotted time.