Description

• Receive assignments and review claim and policy information to support the investigation and determine the extent of the policy's obligation to the insured, depending on the line of business.
• Contact, interview, and obtain statements from insureds, claimants, witnesses, police officers, and others as needed to gather relevant claim information.
• Inspect and appraise damage for property losses, or arrange for such appraisal when appropriate.
• Evaluate facts gathered through investigation to determine the extent of liability, if any, and the company's obligation under the policy contract.
• Prepare reports related to investigations, settlements, claim denials, and evaluations of involved parties.
• Set reserves within authority limits and recommend reserve changes to the Team Leader.
• Review claim progress and status with the Team Leader and discuss issues and recommended corrective actions.
• Submit unusual or potentially adverse exposures to the Team Leader for review.
• Assist the Team Leader in developing process improvements and methods for handling claims.
• Resolve claims promptly and fairly.
• Obtain releases, proofs of loss, or compensation agreements and issue company drafts for claim payments.
• Notify claimants and insureds/customers when a claim is denied, when applicable.