Claim specialist [h1.location_city]
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Claim specialist • grand rapids mi
- [promoted]
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Auto Damage Claims Representative
This position is responsible for handling low to moderate Personal and Business Insurance Auto Damage claims from the first notice of loss through resolution / settlement and payment process. This may include applying laws and statutes for multiple state jurisdictions. Claim types include multi-vehicle (2 or more cars) auto damage with unclear liability and no injuries. Will also handle more complex Auto Damage claims such as non-owned vehicles, fire / theft, and potential fraud as well as non-auto, property related damage. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This role is eligible for a sign on bonus.
What Will You Do?
- Delivers consistent service quality throughout the claim life cycle, including but not limited to prompt contact, explaining the process, setting expectations, on-going communication, follows-through and meeting commitments to achieve optimal outcome on every file. Fulfills specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC).
- Reviews and analyzes coverage and applies policy conditions, provisions, exclusions and endorsements for Auto Damage only claims in assigned jurisdictions. Addresses proper application of any deductibles and verifies benefits available and coverage limits that will apply. Confirms priority of coverage (i.e. primary, secondary, concurrent) and takes into consideration other issues relevant to the jurisdiction.
- Investigates each claim to obtain relevant facts necessary to determine coverage, causation, extent of liability / establishment of negligence, damages, contribution potential and exposure with respect to the various coverages provided through prompt contact with appropriate parties (e.g. policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, etc.) Takes recorded statements as necessary.
- Recognizes and requests appropriate inspection type based on the details of the loss and coordinates the appraisal process. Maintains oversight of the repair process and ensures appropriate expense handling.
- Refers claims beyond authority as appropriate based on exposure and established guidelines. Recognizes and forwards appropriate files to subject matter experts (i.e., Subrogation, SIU, Property, Adverse Subrogation, etc.).
- Establishes timely and maintains appropriate claim and expense reserves. Manages file inventory and expense reserves by utilizing an effective diary system, documenting claim file activities to resolve claim in a timely manner.
- Determines settlement amounts based upon appraisal estimate, negotiates and conveys claim settlements within authority limits to insureds and claimants. As appropriate, writes denial letters, Reservation of Rights and other necessary correspondence to insureds and claimants.
- May provide support to other parts of Auto Line of Business (e.g. Total Loss, Salvage, etc.) when needed.
- In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
- Perform other duties as assigned.
What Will Our Ideal Candidate Have?
What Is a Must Have?
What Is in It for You?
Employment Practices
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit http : / / careers.travelers.com / life-at-travelers / benefits / .