The Claims Specialist investigates, evaluates, and resolves litigated and non-litigated insurance claims of medium complexity. They are responsible for managing litigation, establishing reserves, and negotiating settlements while maintaining compliance with regulatory standards.
Company Details
Company Description
Vela Insurance Services provides specialized Excess and Surplus Lines Casualty and Professional Liability insurance solutions in the following four market segments.: Construction, Specialty Casualty, Velocity Smal Business & Professional Liability. We offer national service and local knowledge to our exclusive wholesale broker network and the businesses they serve.
Responsibilities
Job Description: Overall Position Summary/Purpose
The Claims Specialist investigates, evaluates, negotiates, and resolves litigated and non-litigated property damage, personal and advertising injury, and claims of medium exposure and complexity. This individual will work under limited supervision, with a remote manager.
Key Functions/Duties of Position: Describe the overall job responsibilities
Analyze coverage, identify coverage issues, and prepare coverage letters for supervisor approval
Investigate and evaluate liability
Investigate and evaluate damages
Manage litigation by assigning counsel from the approved panel where applicable, establish litigation plan and budget, coordinate with defense counsel, and continuously review the potential for resolution.
Establish timely reserves within authority and re-evaluate throughout the life of the claim
Maintain up-to-date, appropriate file documentation and written file notes
Maintain an active diary and productive file inventory
Timely completion of all required large loss reporting
Negotiate settlements within authority limit granted, and attend mediations, Mandatory Settlement Conferences, and/or Alternative Dispute Resolutions
Proactively control the work product and expense of outside vendors
Develop and maintain positive customer relationships and provide superior customer service
Timely identify all potential opportunities for co-insurance, transfer of risk and/or subrogation
Ability to Work with designated assigned accounts
Recognize and investigate fraud
Comply with deductible/self-insured retention recovery protocol
Meet and maintain all State licensing requirements at all times (see qualifications below)
Adhere to all statutory regulations, Unfair Claims Practices acts, and corporate Best Practices
All other duties as assigned
Qualifications
Education Requirement:
Four (4) year College Degree, or commensurate experience and training
AIC, SCLA, CRIS or other similar industry designations preferred
Qualifications:
3-5 or more years claims handling experience or equivalent experience.
In-depth knowledge of the insurance industry, including legal and regulatory environments.
A strong functional and developing knowledge of substantive laws and legal procedures.
Applicable adjusters license(s) to include: CA, CT, DE, FL, KY, LA, NH, NM, NC, OK, RI, SC, TX, VT, WV, WY
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