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Claims Specialist - Auto

Company Name:
American National Family Of Companies

job
Responsibilities:
Assume responsibility for complex injury claims, including soft tissue, serious fractures, fatalities, disfigurements, umbrella, high limit policies, etc.
Review facts of loss and details of coverage via the
computer
system.

Determine investigative needs to assess liability and set proper reserves.

Document computer log with results of review and intentions for handling.

Contact relevant parties. Take recorded statement, discussing liability, any MIST issues, identify SIU factors, etc. Explain claims process, medical forms and coverages. Document contact with all parties. Send appropriate medical forms.

Determine inspection needs, order police reports, scene investigation, take witness statements, review Material Damage photos, order medical reports, etc. Assess any follow-up investigative needs and continually assess appropriate reserves.

Compile information for decision making with recognition/discussion of claims committee and reinsurance issues, where appropriate. Evaluate the medical injury exposure within guidelines, research & review appropriate statutes and case law for relevance to claim issues, and make appropriate and timely payments.

Communicate and negotiate decision with appropriate parties to conclusion.
Job Requirements:
Education Equivalent: College degree required or equivalent industry experience or advanced degree. Insurance training required. Prior experience as a Bodily Injury Claims Adjuster required. Successful completion of requirements defined by Claims Career Path guidelines.

Specific Training: Advanced training/experience in determining liability negotiating settlements and reviewing estimates. MS Word and Outlook experience/proficiency preferred.

Specific Knowledge: Advanced knowledge of policy forms, coverages, medical terminology and injury evaluation.

Specific Abilities: Ability to independently assess facts, and make decisions concerning coverage. Ability to work with insureds, claimants, attorneys and other professionals in an effective manner. Excellent oral and written communication skills required. Ability to plan, prioritize, and organize.


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