Claims representative Jobs in Carrollton, TX

Claims Manager Employment Practices Liability Division

Group Claims Reports To: As per Beazley's organization chart Key Relationships: Group Claims Management Team, Claims Team Leaders ("CTLs"), Underwriting & Claims Operations ("UCO"), Underwriters, Ceded Reinsurance, clients, brokers, and key external vendors.

Job Summary: An independent claims handler who will manage and oversee the end-to-end claims process for a wide variety of matters under Employment Practices Liability policies. Supports Beazley's vision of being the highest performing sustainable specialty insurer through proactively managing claims, at an individual and portfolio level where required.

Key Responsibilities:

• Individual Claims Management
• Proactively manage a diverse portfolio of Employment Practices Liability claims.
• Handle claims from first notice of loss through resolution, assessing severity, complexity, and direct financial loss to determine the appropriate level of involvement based on claim type, maturity, and quantum, while working closely with brokers, insureds, and underwriting partners.
• Evaluate policy coverage in line with underwriting intent, draft clear and well-reasoned coverage position letters, and effectively communicate coverage determinations to brokers, insureds and other relevant stakeholders in accordance with Beazley's Claims Service Standards.
• Manage portfolio of medium to high severity claims, including Category 2 and some Category 1 claims (i.e., claims with an expected or actual value in excess of $500,000 or having material coverage issues) including (depending on training and agreement of the Head of) Coverage Litigation but without allegations of bad faith.
• Review of individual claims within the portfolio on a regular basis ensuring claims records are maintained in a timely manner as required by Beazley's claims controls and standards as well as regulatory minimums.
• Establish appropriate and timely case reserves adhering at all times to Beazley's authority protocols and Beazley's Claims Reserving Philosophy and Standards while using all tools available to demonstrate potential loss exposure.
• Develop, iterate, document, and execute claims strategies taking into account uncertainties, key decisions, potential outcomes, and estimated associated costs.
• Ensure the management of claims conforms to the agreed standardized processes, maintain accurate and updated claims files including proper documentation and data.
• Communicate any material claims to Reinsurance and Finance as set out by the applicable claims authority, claims controls/protocols, and procedures. Working with Reinsurance to effect claims recoveries.
• Strategy and Business Planning
• Maintain an awareness of the overall strategic objectives and business plans of the Beazley claims function to the degree required to identify gaps or future opportunities to Claims Management.
• Working with Underwriters and Claims Team
• Understand marketing and underwriting strategies for the business area.
• Where requested, join client meetings to share Beazley's claims philosophy and address specific claims issues.
• Provide input to underwriters of potential or existing insured's claims experience.
• Identify issues and trends, consult relevant stakeholders if required, and take appropriate and/or corrective action.
• Identify wordings issues and suggest policy wording improvements.
• Leverage networking opportunities within the business to develop standardized underwriting policy and best practices within Beazley.
• Work with Claims team members and underwriters to maximize business opportunities and profitability within the department including sharing market information, marketing sources and cross-selling opportunities.
• Help produce presentations and marketing literature as required.
• Authority & Minimum Standards Observance
• Operate within approved claims authority at all times.
• Maintain a thorough knowledge of and ensure compliance with relevant regulation, minimum claim handling standards and Beazley's claims controls and protocols.
• Third Party Management
• Adhere to Beazley's procedures for the selection and retention of 3rd party professionals.
• Where applicable, appropriately manage escalation of items from delegated partners.
• Where applicable, conduct file reviews or audits as required, and resolve any issues identified.
• Where applicable, provide feedback on a regular and proactive basis regarding the claim actions undertaken by the Third-Party Administrator (TPA).
• Where applicable, propose strategies for future claims handling, review case reserve adequacy, and ensure the TPA remains focused on claim finalization.
• Broker and Insured Relations
• Work proactively to develop and maintain strong relations with key brokers and insureds.
• Promote the Beazley brand of excellence and professionalism in client service.
• Conflicts of Interest
• Adhere to Beazley's Conflicts of Interest policy, alert the appropriate person to any potential conflicts of interest, and take steps to resolve them promptly.
• Immediately advise your Head of or Group Head of Claims if any Beazley employee seeks to exert undue influence on you or any other team member to act improperly in the management, reserving, or settlement of any claim.
• General
• It is important that within all your interactions both internally and externally you adhere to Beazley's core values - Being Bold, Striving for Better, and Doing the Right Thing as they contribute to an internal environment of teamwork and promote a positive brand image and experience to our external customers.
• We also expect Beazley employees to:
• Comply with Beazley procedures, policies and regulations including the code of conduct, which incorporates the PRA and FCA Conduct.
• Undertake training on Beazley policies and procedures as delivered by your line manager, the Culture & People or assurance teams (compliance, risk, internal audit) either directly, via e-learning or the learning management system.
• Display business ethics that uphold the interests of all our customers.
• Ensure all interactions with customers are focused on delivering a fair outcome, including having the right products for their needs.
• Comply with any specific responsibilities necessary for your role as outlined by your line manager, the Culture & People or assurance teams (compliance, risk, internal audit) and ensure you keep up to date with developments in these areas.
• This may include, amongst others, Beazley's underwriting control standards, Beazley's claims control standards, other Beazley standards and customer relationship management.
• Carry out additional responsibilities as individually notified, either through your objectives or through the learning management system. These may include membership of any Beazley committees or working groups.

Education and Qualifications

• College degree. J.D. preferred but not required.
• Three or more years' experience independently managing EPL claims from notification through closure, with a proactive, end-to-end approach across varying claim types, complexity levels, and exposures.
• Adjuster license(s) may be required as part of your job responsibilities. If required, those licenses must be obtained within the first 90 days of your employment and in accordance with an individual licensing plan established by Beazley Compliance and your Manager.

Skills and Abilities

• Analytical skills: Problem solving (broad-based, analytical, conceptual, creativity), analysis of financial statements, financial assessments of claims, data analysis and decision-making
• Work management skills: Time and workload management, self-starter, planning, achievement orientation, productivity focused
• Interpersonal skills: Ability to influence others, client and broker management skills, purposeful communication, flexibility, active listening
• Knowledge and Experience Legal training or claims experience, including assessing liability and negotiating settlements. Functional expertise includes: claims management procedures, knowledge of both US and international insurance markets (general and specialised areas), familiarity with US and global legal and regulatory frameworks, as well as alternative dispute resolution methods.

Competencies

• Problem-solving
• Decisiveness
• Customer-focused
• Influencing others
• Attention to detail
• Team work
• Self-starter
• Analytical thinking
• Managing resources effectively

Who We Are: Beazley is a specialist insurance company with over 30 years' experience helping people, communities and businesses to manage risk all around the world. Our mission is to inspire our clients and people with the confidence and freedom to explore, create and build to enable businesses to thrive.

Our Culture