Commercial Property Claims Specialist

                                               Commercial Property Claims Specialist       

 SUMMARY:  Investigates and resolves primarily first and third-party property commercial claims to determine coverage and measure damage.  The position will also handle personal lines Property Claims as necessary.  Experience of five or more years of increasing responsibility, and capable of independent claim examination and resolution with minimum supervision.

DUTIES AND RESPONSIBILITIES:  The following are essential functions for this job but do not restrict the work that may be assigned.  The duties and responsibilities of the work assigned or reassigned for this position may change as needed.  

Duties for this position include:

• Investigate and determine coverage via verification and detailed analysis of applicable policy/endorsement contract language in comparison to developed loss facts:
  1. Promptly resolve all open coverage issues through the investigation process.  

• • Protect the company’s coverage defenses by timely drafting and issuing the appropriate non-waiver agreements, reservation of rights, or disclaimer position letters in compliance with each state’s Unfair Claim Settlement Practices Act and insurance code.

• Ensure loss reserves are timely and adequate:

• • Determine claim values through timely investigation, damage measurement, legal liability, and causation.
  • Manage, and ensure reserve adequacy on each claim.

• Timely initiate, conduct, and complete the claims investigation confirming the claim facts, coverage, and damages on all claims or business activities assigned.

• • Identify and deploy appropriate field resources while optimizing loss adjustment expense.
  • Provide written task instructions and supervision to independent investigators and adjusting firms and experts hired.
  • Ensure claim files contain appropriate documentation to justify coverage, legal liability and damage decisions.
  • Recognize and react to potential fraud triggers and engage S.I.U. as appropriate.
  • Identify and initiate timely pursuit of subrogation and salvage recovery opportunities.

• Resolve claims at the earliest possibly opportunity using effective business judgement based upon a timely and complete evaluation of coverage, factual evidence, legal liability and damages:

• • Complete ongoing evaluations on damage values and comparative fault analyses as information is received.
  • Determine excess exposures and timely notify policyholders of such exposures.
  • Utilize alternative dispute options when appropriate. 

• Draft and timely complete the necessary claim status and narrative reports:

• • Ensure that detailed Property financial reports including large loss reports are completed at the appropriate time intervals.
  • Complete reporting to claim files utilizing activity logs.

• Achieve excellent customer service results:

• • Be courteous, polite and honor all commitments.
  • Manage and diffuse conflict in adversarial situations.
  • Return all phone and voice mail messages the same day as received.
  • Participate and handle claims generated during after-hours periods.

• Perform a variety of miscellaneous duties and special projects as assigned, inclusive of catastrophe duty and other in-field based claim resolution activities.

• Maintain state specific adjuster licenses and complete continuing education requirements as required by the states assigned.

1. Master company generated claim and technical procedure manuals.

QUALIFICATIONS:

• Bachelor's Degree from four-year college or university, and a minimum of five years of related experience and/or training, or equivalent combination of education and experience.
•  Strong knowledge of Commercial Property and casualty policies, insurance principles, loss reserving and loss development skills.
• Sound business judgment and effective interpersonal skills
• Excellent loss adjustment expense management skills.  This includes established accounting skills to successfully manage and adjust business interruption claims.    
• Experience managing claims under each state’s Unfair Claim Settlement Practices Acts and Insurance Codes
• Deep experience using estimatics software to measure commercial and personal lines Property Claims.
• Proficient with MS Office suite of products.
• Excellent customer service skills.
• Excellent verbal and written communication skills.
• Strong organizational skills; able to effectively manage competing priorities.
• Obtains and maintains state adjuster licensing as required. 
• Experience with litigation management a plus.
• Demonstrated problem solving capability. 

 COMPETENCIES: 

• Problem Solving - Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics.

• Project Management - Develops project plans; coordinates projects; communicates changes and progress; completes projects on time and budget; manages project team activities.

• Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions; demonstrates group presentation skills; participates in meetings.

• Written Communication - Writes clearly and informatively; edits work for spelling and grammar; varies writing style to meet needs; presents numerical data effectively; able to read and interpret written information.

• Customer Service - Manages difficult or emotional customer situations; responds promptly to customer needs; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitments.
• Curiosity – demonstrate an interest in learning root causes of business and operation problems and refining effective solutions. 

• Ethics - Treats people with respect; keeps commitments; inspires the trust of others; works with integrity and ethically; upholds organizational values.

PHYSICAL:

While performing the duties of this job, the employee is regularly required to stand, walk; sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee must regularly lift and/or move up to 5 pounds, occasionally up to 10 pounds. 

The job may involve working outside normal business hours, or outside the scope of the position, depending on skills and business needs.  Additionally, travel may be necessary on short notice nationally to perform the duties of the position.    

WORK ENVIRONMENT:  The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  

The noise level in the work environment is usually moderate.

REPORTING RELATIONSHIP:  Reports directly to claims manager and/or claims supervisor.