Primary Responsibilities:
Utilizes acceptable investigation claims handling and settlement techniques that achieve cost effective and timely closure results by obtaining, reviewing and analyzing documentation, policy provisions and other records. May require additional contact with other parties (i.e. employer, claimants, third parties such as medical providers, auto repair centers, etc.) as deemed necessary. Utilizes diary system to pro-actively resolve outstanding issues and to ensure timely processing and closure of claim.
Provides timely service throughout the life of the claim by meeting all service level agreements, initiating timely contact to all appropriate parties, and responding to incoming inquires according to company policy and procedures.
Maintains accurate system data and documentation by collecting, recording, analyzing, and summarizing information. Determines and timely sets appropriate reserves within authority level. Identify subrogation opportunities and fraud potential and make appropriate referrals. Managing key claims handling enquiry; coverage determination, quantum analysis and legal liability assessment, where appropriate within authority limits and providing a high standard of customer service. Work with Team Manager/Senior Adjuster to ensuring effective vendor and litigation management on Complex claims within a personal allocation. internal stakeholder communication where required Strive for continuous improvement on claim file handling with feedback and support through the Quality Assurance Review processes Contribute to maintenance of best practice procedures for Auto Complex claims, consistent with global best practice. Demonstrate a basic standard of technical claims competence for handling moderate to lower complexity complex claims. Handle complex claims allocated within agreed level of authority limit
Timely, accurate and customer focused claim resolution, minimising indemnity exposure and mitigating vendor and legal expense. Effective communication of key Complex claims and Auto portfolio messages to internal stakeholders. Financial control through consistent reserve and other financial transaction discipline. Accurate and consistent policy interpretation