Sr. Claim Rep - General Liability; Homeowner​/Dwelling​/Business

Sr. Claim Rep - General Liability (Homeowner/Dwelling/Business)

Company:
Vermont Mutual Insurance Group

Location:

Remote for candidates located in the Northeast U.S.

Base pay range: $65,000 – $85,000 per year.

Employment type:

Full‑time;
Seniority level:
Mid‑Senior level;
Job function:
Business Development, General Business, and Customer Service. Industry: Insurance.

Directly handle a diverse claims caseload, including multiple coverage feature types and a large percentage of losses of moderate complexity and financial severity. Claims involve coverage issues or litigation. Employee should possess demonstrated expertise in handling significant bodily injury claims which involve comparative negligence theories and defenses. The role requires a deep understanding of all coverage wrote with an emphasis on more difficult losses and exposures, and the capability to see complex adjustments through final resolution using a wide variety of settlement techniques.

Conclude claims promptly and equitably within the provisions of the policy contract and in accordance with known damages and legal requirements. All files handled must comply with claim handling guidelines and all other job expectations, regulations and requirements.

• Conduct and coordinate loss investigations on all assigned claims.
• Negotiate the settlement of claims within authorized amounts or specific file authority; maintain accountability for all assigned claims until disposition is reached.
• Recommend further action on claims exceeding authority limits.
• Document all activity on assigned claims and assist in the control of independent vendors.
• Review new losses and files on diary to ensure reserve adequacy while keeping management informed of adverse developments.
• Monitor loss adjustment expenses and take steps to effectively manage costs of third‑party service providers.
• Utilize vendors judiciously to ensure maximum value from services.
• Review coverage questions and suggest interpretations to Claim Supervisor for approval.
• Refer appropriate coverage matters to the Claim Supervisor and/or Claim Manager.
• Ensure appropriate file handling, documentation, special reporting and expense control of all files handled inclusive of MSP compliance.
• Provide accurate, courteous and timely information to all eligible external and internal customers concerning claim status and other claim inquiries.
• Present reports naga lead discussion on files requiring round‑table reviews with peers and management.
• Provide service calls on policyholders and agencies as needed.
• Draft coverage correspondence, including reservation of rights and coverage disclaimer, and compose detailed correspondence to insureds, claimants, attorneys, etc.
• Attend trials, depositions, EUO’s and mediations where deemed beneficial or required by jurisdiction. Suggest improvements to processes within the department to increase the level and quality of service provided to internal and external customers, e.g., workflow changes, systems implementation, etc.
• Effectively follow direction on complicated or high‑exposure matters and recommend appropriate reserves/custom handling on claim files within specific authority and on files requiring mandatory reporting to management.
• Performs other duties or special projects as required or as assigned.

• Bachelor’s degree in business, insurance or a related field, or its equivalent.
• Five or more years of relevant technical claim handling experience with demonstrated achievement and progressive responsibilities, or a combination of education and experience that provides comparable knowledge and skills.
• Appropriate state Adjusterdés’ License(s) where required ultima by law.
• Advanced knowledge of the technical aspects of casualty claims.
• Demonstrated commitment to professional development through the attainment of recognized industry designations such as AIC, AEI, SCLA, CPCU programs, etc.
• Fully developed skills in specialized technical disciplines; including extensive knowledge of relevant contract and tort law.
• Sound understanding of the insurance industry and company operations. Strong analytical and negotiating skills.
• Very good oral and written…