General Position Summary
The Claims Adjuster II is responsible for the investigation, evaluation, negotiation, and resolution of basic to moderate property or casualty claims, including Personal, Farm, General Liability and Commercial lines claims with injuries and/or property damage. Responsibilities also include providing exceptional customer service, thorough coverage analysis, communication with insureds and other interested parties, complying with file requirements, and making recommendations to management pertaining to company coverage and/or settlement positions.
Essential Functions for this role include:
- Ascertains validity of claims, verifies coverage, determines liability, determines extent of the value of a claim and negotiates settlements within prescribed limits of authority, in accordance with established procedures and consistent with legal and contractual obligations, as well as state statutes and Department of Insurance requirements.
- Works with insureds, claimants, agents, attorneys, witnesses, repair shops, service providers and others to bring assigned claims to prompt conclusion.
- Communicates with insureds, claimants and other interested parties over the telephone and in written correspondence relating to claims adjusting and settlement activities.
- Maintains current knowledge of policy coverages, developments in tort law and damage-related issues.
- Assists supervisors in maintaining proper reserving.
- Alerts the Underwriting Department of questionable risks or potential hazards.
- Submits prompt and concise reports containing all information and evidence developed in the investigation.
- Maintains a diary system to ensure all claims are properly and adequately handled to conclusion.
- Maintains the confidentiality of claim information.
- Investigates and documents all subrogation possibilities.
- Overnight travel may be required, including travel associated with large loss and catastrophe claim handling.
- Inspects and documents property damage associated with claims.
- Obtains or constructs repair estimates for structures.
- Other responsibilities and duties as assigned.
- Meet expectations of attendance and punctuality.
- Serve as back-up to other team members, including support staff when needed.
- Actively participate in continuing education.
- Present a professional and helpful appearance.
Required Knowlesge, Skills and Abilities:
- Skills described in job description.
- Ability to learn and apply knowledge of insurance contracts, claim policies and procedures, and customer service philosophies.
- Ability to communicate clearly, professionally, and empathetically both in person and on the telephone. Must be able to timely and effectively communicate with insureds, mortgagees, lien holders, claimants, attorneys, agents, medical providers, vendors and others through frequent written and telephone communication.
- Ability to cultivate and maintain constructive working relationships despite differing perspectives.
- Ability to empathize with, actively listen to, and deal sensitively and professionally with insureds and claimants.
- Strong organizational and time management skills.
- Ability to develop strong negotiation skills.
- Ability to learn and utilize computer systems and other technologies.
- Ability to maintain quality work product and professionalism, even when work volume is high.
- Ability to think critically and anticipate, recognize, identify and develop solutions to problems in a timely manner.
- Ability to work independently, as well as in a team environment.
- Satisfactory work history and excellent attendance record.
- Knowledge of insurance contracts including property, builders risk and inland marine lines of business.
- Must possess a valid driver’s license supported by a good driving history and have the ability to travel frequently. Overnight travel is required, with some overnight travel over extended periods of time
- Ability to work outside in all temperatures and inspect property physically and visually.
- Ability to climb a ladder, lift moderate loads, and stand on tall structures and roofs.
- Bachelor’s degree (B.S./B.A.) from a four-year college or university (preferred); or
- Associate’s Degree plus 1-2 years of related work experience (preferably in the insurance industry); or
Industry Education and Experience:
- Associate in Claims (AIC); and
- Three or more years claims adjusting experience.
- Equivalent combination of industry education and experience may be substituted for the above.