Claims assistant serp_jobs.h1.location_city

MSIG USA Claims Adjuster

MSIG USA is the US-based subsidiary of MS&AD Insurance Group Holdings, Inc., one of the world's top P&C carriers and a global Class 15 insurer, with A+ ratings and a reach that spans 40+ countries and regions. Leveraging our 350-year heritage, MSIG USA brings the financial strength, expertise, and global footprint to offer commercial insurance solutions that address your business's unique risks.

Summary / Job Purpose :

This position is responsible to conduct thorough investigations and evaluate and negotiate complex claims including litigation and coverage issues. Accountable to ensure compliance with MSMM Claim Handling Guidelines, including reserving and payment practices, regulatory requirements and Fair Claims Practices Acts.

Essential Functions :

Investigates, researches and analyzes highly complex or severe claims, including coverage issues and legal issues affecting liability and damages.

Establishes appropriate case reserves, completes settlements and case resolutions within established reserve and settlement authorities. Recommends reserve and settlement values on assigned cases in excess of established reserve and settlement authority.

Manages, controls and negotiates timely and equitable claim payments and settlements in accordance with jurisdictional and fair claim practices and company policy and procedures.

Attends pre-trials, trials, settlement conferences and mediations on assigned cases as required

Assigns the defense of lawsuits to approved defense counsel; directs and monitors quality and performance of defense counsel. Maintains compliance with all requirements of the company's Litigation Management Program. Reviews and adjusts, where appropriate, fee bills and legal expenses for accuracy and reasonableness.

Services the claim needs of our customers including insureds, claimants, brokers, etc., in accordance with company policy and procedures, and attends client visitations with underwriters and other parties to conduct presentations and reviews.

Maintains ongoing communication with all customers throughout the claims process in an effort to provide timely and appropriate claim status as appropriate and / or required by statutory regulations.

Completes timely and accurate data reports to state reporting agencies to ensured full compliance with MSMM and regulatory requirement.

Maintains full compliance with all regulatory Fair Claim Practices Acts and state and federal regulations.

Maintains full compliance with all state licensing and continuing education requirements to ensure current and appropriate filing / standing of all adjuster licenses.

Maintains regular reporting of case status, developments and direction to Home Office staff and other appropriate parties as necessary. Ensures timely and appropriate file reports and system documentation as required by company claim manuals and procedures.

Participates and / or manages special projects and assignments as needed.

Supervisory Responsibilities :

This position has no supervisory responsibilities.

Qualifications :

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and Experience Required :

Diploma / Degree & Experience

High School Degree or G.E.D. is required. Bachelor's degree preferred

7+ years related experience handling complex Liability or Workers' Compensation Claims

It's an exciting time for our company and a great opportunity to join a financially sound and growing global insurance group!

It is the policy of MSIG USA to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and / or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, MSIG USA will provide reasonable accommodations for qualified individuals with disabilities.