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Claims Specialist

Posted 4 days ago
2-5 years experience
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AI Summary

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

 

Sponsorship Details

Sponsorship not Offered for this Role

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