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Casualty Claims Specialist

Job Description - Casualty Claims Specialist

Description

Overview: As the Casualty Claims Specialist, you will be responsible for managing injury and damage claims in personal and commercial auto, as well as general liability cases.

Key Responsibilities:

  • Analyze initial reports to determine the nature of loss, coverage provided, and the scope of injury or damage in both personal and commercial auto, as well as general liability cases.
  • Conduct comprehensive investigations into all aspects of reported claims, including potential fraud. Secure appropriate supporting documentation and verify its accuracy, relevance, and completeness.
  • Manage first and third-party injury claims related to No-Fault/Med Pay and liability exposures.
  • Apply knowledge of jurisdictional regulations and case law applicable to all territories handled.
  • Negotiate liability and damages effectively when appropriate.
  • Demonstrate the ability to manage and monitor cases to ensure timely development and resolution of claims inventory.
  • Collaborate with department management to deliver presentations, conduct meetings, and serve as a technical resource.    

Desired Skills:

  • Comprehensive understanding of insurance contracts, investigation techniques, legal requirements, and insurance regulations.
  • Strong ability to evaluate, analyze, and interpret policy language, contracts, and other complex information.
  • Excellent verbal and written communication skills, with the ability to clearly explain coverage positions, claim decisions, and recommendations.
  • Strong analytical and critical thinking skills with the ability to assess claim facts, identify key issues, and determine appropriate next steps.
  • Ability to manage multiple claims simultaneously while maintaining accuracy, organization, and attention to detail.
  • Demonstrated negotiation skills with the ability to resolve liability and damages effectively when appropriate.
  • Sound judgment and decision-making skills, particularly in complex or sensitive claim situations.
  • Ability to work independently while also collaborating effectively with management, peers, and other internal stakeholders.
  • Strong customer service orientation with the ability to handle challenging conversations professionally and tactfully.
  • Ability to adapt to changing priorities, deadlines, and claim environments.
  • Familiarity with litigation management and the ability to support claims through the litigation process.
  • Proficiency in documenting claim activity thoroughly and maintaining clear, accurate file notes.
  • Ability to identify potential fraud indicators and escalate concerns appropriately.
  • Strong presentation and facilitation skills, with the ability to contribute in meetings and serve as a technical resource.
  • Commitment to continuous learning and staying current on jurisdictional regulations, case law, and industry best practices.


Qualifications
  • 5-7+ years of experience in liability insurance claims adjusting, including litigation.
  • Bachelor’s Degree or equivalent experience.
  • If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.


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