Casualty Claim Representative

Job Summary
Works within specific limits and authority on casualty claim assignments of moderate technical complexity. Determines coverage and investigates, analyzes, negotiates and settles claims

while delivering quality customer service in a high volume, low to moderate complexity work environment.
 
Essential Functions(primary functions and/or reasons the job exists in order of importance)

  1. Coverage/Investigation/Liability - Determines whether or not proper coverage exists for the type of claim assigned.  Investigates thoroughly to obtain relevant facts concerning all aspects of the claim, such as coverage, liability, legal climate, potential exposure, and damages, and makes decisions, where appropriate, on claim resolution.  Monitors ongoing case development for appropriateness.

  2. Damages - Determines the value of the physical damage of property, automobiles, or injuries through inspections and use of appropriate tools.  Obtains all necessary documentation to support claim evaluation. Recognizes claim file exposures and escalates appropriately.   

  3. Communication - Maintains effective and ongoing communications with insureds, claimants, agents, attorneys, other insurance companies, representatives, vendors, and company personnel. 

  4. Customer Service - Ensures customer service excellence.  Responsible for the customer and agent experience associated with assigned claims.

  5. Reserving/Reporting - In accordance with Westfield's reserving philosophy, establishes and reviews proper reserves for each claim based upon thorough investigation, evaluation, and experience.  Completes appropriate reports so that the current status of the claim is clearly documented at all times.

  6. Negotiation/Settlement - Within decision making authority, negotiates timely and appropriate settlements with insureds, claimants, vendors, attorneys, and other insurance companies.  Refers claims exceeding authority to appropriate leader or complex claims specialist with recommendations.

  7. Travels as often as needed including regular utilization of fleet vehicle in order to cover assigned territory.  This may involve traveling on short notice or other daily driving duties as assigned regardless of location.


 
Desired Qualifications/Experience/Certification/Education(in order of importance)



  1. Ability to handle casualty claims with exposure up to $25,000.

  2. 2 or more year's equivalent claims adjusting/industry related experience orfive years as a Claims Administrative Assistant.

  3. Strong oral, written, and interpersonal communication skills.

  4. Proficient use of various core systems, office and computer equipment and software packages.

  5. Insurance industry designation such as AIC, SCLA, CPCU, etc.

  6. Valid driver's license and a driving record that conforms to company standards.

  7. Bachelor's Degree or commensurate experience.


 
Physical Requirements(specific to the role)                                            
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. 



  • Ability to work effectively in an office environment for 40+ hours per week (including sitting, standing and working on a computer for extended periods of time).

  • Ability to communicate effectively in a collaborative work environment utilizing various technologies such as:  telephone, computer, web, voice, teleconferencing, e-mail etc.

  • Ability to travel as required.

  • Ability to operate an automobile within the parameters of the driving policy.

  • Ability to drive for extended periods of time, under a variety of conditions, including night driving.


 
This job description describes the general nature and level of work performed in this role. It is not intended to be an exhaustive list of all duties, skills, responsibilities, knowledge, etc. These may be subject to change and additional functions may be assigned as needed by management.
 
Member companies of the Westfield Group are Equal Opportunity Employers (M/F/Disabled/Protected Veteran).

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