Description

• Receive assignments and review claim and policy information to provide background for investigation; may determine the extent of the policy's obligation to the insured, depending on the line of business.
• Contact, interview, and obtain statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, and other relevant parties to gather necessary claim information.
• Inspect and appraise damage for property losses or arrange for such appraisals, as required by the line of business.
• Evaluate facts obtained during investigations to determine the extent of liability and the company's obligation under the policy contract.
• Prepare reports on investigations, settlements, denials of claims, and individual evaluations of involved parties.
• Set reserves within authority limits and recommend reserve changes to the Team Leader as appropriate.
• Review the progress and status of claims with the Team Leader, discussing challenges and suggesting remedial actions.
• Prepare and submit to the Team Leader any unusual or potentially undesirable exposures.
• Assist the Team Leader in developing methods and improvements for handling claims.
• Settle claims promptly and equitably.
• Obtain releases, proofs of loss, or compensation agreements, and issue company drafts for claim payments.
• Inform claimants, insureds, customers, or attorneys of claim denials when applicable.