Description

• 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.

• 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.