P&C Sr. Claims Adjuster
The Sr. P&C Claims Adjuster is responsible for conducting investigations, evaluations and disposition of coverage and damage issues on claims and for recovering damages from at fault individuals or organizations in behalf of American Reliable Insurance Company and our insured.
- Adjust claims according to applicable laws and policy provisions and comply with all Department of Insurance Regulations.
- Recognize critical files and immediately report them to management. Consult with management on files involving complicated negotiations, applicable compromise recovery agreements and complex liability litigation.
- Confirm coverage and recognize coverage issues. Resolve complex issues and refer any issues as necessary
- Conduct investigations including interviews, record statements, secure public records, and obtain documents. Review all referred files for adequacy of documentation and investigation. Refers incomplete investigations to the original handling adjuster
- Maintain mail, diary and phone calls within company standards.
- Recognize and document subrogation and salvage opportunities and refer to correct area.
- Issue payments or deny claim in accordance with policy conditions and quoting policy language to the correct parties in a timely manner within authority level and seek approval when above authority.
- Review and audit estimates received.
- Handle complex property claims/subrogation in a self-sufficient manner. Files assigned usually have greater degree of complexity. Could handle litigated files.
- Helps establish procedures and process to streamline claim function.
- Applies expert problem solving skills to the most complex of issues.
- Applies sophisticated negotiating techniques.
- Recognize and recommend areas needing improvement.
- College Degree and or equivalent work experience
- 5-6 years prior claim experience or 6+ years prior experience in similar industry