Claim Technical Specialist - Construction Defect JobClaim Technical Specialist - Construction Defect Job
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Date:Nov 12, 2011
Location:Las Vegas, NV, US
Solid reputation, passionate people and endless opportunities.
That's Travelers. Our superior financial strength and consistent record of strong operating returns mean security for our customers - and opportunities for our employees. You will find Travelers to be full of energy and a workplace in which you truly can make a difference.
SUMMARY:
Investigate, evaluate, reserve, negotiate and resolve assigned claims in accordance with Best Practices. Provide quality claim handling and superior customer service on assigned claims while engaging in indemnity & expense management. Promptly manage claims by completing essential functions including contact, investigation, damages development, evaluation, reserving, litigation management, and disposition. Provides consulting and training resources, and serves as a contact and technical resource to the field and our business partners.
PRIMARY DUTIES:
Directly handle assigned severe claims.
Provide quality customer service and ensure file quality timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case.
Consult with Manager on use of Claim Coverage Counsel as needed.
Directly investigate each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Interview witnesses and stakeholders, take necessary statements, as strategically appropriate. Complete outside investigation as needed per case specifics.
Actively engage in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subro, Risk Control, nurse consultants nurse consultants, and fire or fraud investigators, and other experts.
Verify the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation.
Maintain claim files and document claim file activities in accordance with established procedures Utilize evaluation documentation tools in accordance with department guidelines.
Proactively review CFAs for adherence to quality standards and trend analysis.
Utilize diary management system to ensure that all claims are handled required time intervals, evaluate liability & damages exposure.
Establish and maintain proper indemnity & expense reserves.
Recommend appropriate cases for discussion at roundtable.
Attend and/or present at roundtables/ authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expense
Actively and enthusiastically share experience and knowledge of creative resolution techniques to improve the claim results of others.
Apply the Companys claim quality management protocols, Best Practices and metrics to all claims; document the rationale for any departure from applicable protocols and metrics with or without assistance.
Develop and employ creative resolution strategies.
Responsible for prompt and proper disposition of all claims within delegated authority. Negotiate disposition of claims with insureds and claimants or their legal representatives. Recognize and implement alternate means of resolution.
Manages litigated claims. Develop litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers.
Apply litigation management through the selection of counsel, evaluation and direction of claim and litigation strategy.
Track and control legal expenses to assure cost-effective resolution.
Effectively and efficiently manage both allocated and unallocated loss adjustment expenses.
Attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
Update appropriate parties as needed, providing new facts as they become available, and their impact upon the liability analysis and settlement options.
Recognize cases, based on severity/complexity protocols, that should be transferred to another level of claim professional and refer on a timely basis.
Appropriately deal with information that is considered personal and confidential.
Fulfill specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC) instructions, and inquires from agents and brokers.
Represent the company as a technical resource, attend legal proceedings as needed, act within established professional guidelines as well as applicable state laws
Actively provide mentoring and coaching to less experienced claim professionals to increase the technical expertise and improve bench strength.
Share accountability with business partners to achieve and sustain quality results.
Evaluate all claims for recovery potential; directly handle recovery efforts and/or engage and direct Company resources for recovery efforts.
EDUCATION/COURSE OF STUDY:
College degree or equivalent in business experience preferred
Advanced level knowledge and skill in claim and litigation.
Basic working level knowledge and skill in various business line products
Strong negotiation and customer service skills
Skilled in coverage, liability and damages analysis and has a thorough understanding of the litigation process, relevant case and statutory law and expert litigation management skills.
Extensive claim and/or legal experience and thus the technical expertise to evaluate severe and complex claims.
Able to make independent decisions on most assigned cases without involvement of supervisor.
Openness to the ideas and expertise of others actively solicits input and shares ideas.
Thorough understanding of commercial lines products, policy language, exclusions, ISO forms, and effective claims handling practices.
Demonstrated coaching, influence and persuasion skills.
Advanced written and verbal communication skills are required so as to understand, synthesize, interpret and convey, in a simplified manner, complex data and information to audiences with varying levels of expertise.
Can adapt to and support cultural change
Strong technology aptitude; ability to use business technology tools to effectively research, track, and communicate information.
CERTIFICATES/DEGREES:
State insurance adjusting license (where applicable) and ongoing satisfaction of any necessary continuing education requirements.
OTHER:
Leading the Business:
Drive Results
Leads Change
Executes Business Strategy
Leading Others:
Attract Top Talent
Maximize Individual Performance
Holds Others Accountable
Aligns Rewards
Creates and Sustains a Dynamic Workplace-promotes Enterprise culture
Leading Self-Emotional Intelligence
Demonstrates Self-Awareness-initiative and accountability
Applies Critical Thinking
Communicates Effectively & Influences Others
Exhibits Courage, Conviction & Credibility
Incumbents who fill this position will be subject to periodic post-hire criminal background checks while employed in this position. As a condition of acceptance for the position, selected candidates for this position will be required to electronically accept the Fair Credit Reporting Act (FCRA) Disclosure Statement and Authorization included in the online employment application. You may also be subsequently asked to accept similar FCRA authorizations periodically throughout your employment with the Company.
Travelers is an equal opportunity employer. We actively promote a drug-free workplace.
Job Category: Claim>
Nearest Major Market:Las Vegas
Job Segments:Claims, Construction, Consulting, Customer Service, Engineering, Finance, Insurance, Law, Legal, Liability, Quality, Quality Manager, Research, Risk Management, Technology
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