Senior Claims Adjuster, Insurance

Job Summary

Investigate, evaluate, and adjudicate claims for workplace injuries that fall under an occupational accident policy, which covers non-traditional workers such as independent contractors and / or commercial truck drivers. This includes, but is not limited to, coverage verification, medical management, communicating with Insured's, Claimants, Attorneys and medical experts. It also includes file documentation, negotiating settlements within authority and taking the action necessary to bring all assigned files to a reasonable resolution. We are seeking an experienced adjuster to join our Occupational Accident team. The ideal candidate is knowledgeable or experienced in disability or medical management as well as policy language and interpretation. We also require excellent customer service, clear and effective communication and analytical skills.

Key Responsibilities

• Ensure that claims handling is conducted in compliance with applicable statutes, regulations, and other legal requirements, and that all applicable company procedures and policies are followed.
• Receive new loss assignments and review all information on new loss reports.
• Handle files involving catastrophic injuries in accordance with our Catastrophic Guidelines.
• Interview insured's, claimants, witnesses and investigate loss details as required, including any paper documents that may be required. This includes, but is not limited to; police reports, various public records, Bills Of Lading, lease agreements, releases, Proof of Loss, etc.
• Confirm and evaluate coverage, including coverage dates and appropriate limits, terms and conditions, insuring agreements, etc. Document the file relative to the coverage analysis and prepare any coverage position letter required (i.e. ROR, Denial, Tender Letter, etc.).
• Assign claim to outside appraiser and / or adjuster with instructions for investigation and evaluation as needed.
• Review reports from adjusters and / or appraiser and evaluate, make judgments and formulate action plans to carry claim to final disposition.
• Evaluate all key components of the claim and formulate plan to carry file to conclusion. This includes applying appropriate coverage application, liability analysis, Injury / Damage analysis, settlement value range and action plan to resolve the file;
• Negotiate claim to conclusion with the insured, the claimant or legal representatives, as needed.
• Manage litigated files to conclusion. This includes, but is not limited to; assigning counsel, managing counsel assigned to the case in connection with our Litigation Guidelines and handling all and attorney assigned files in connection with our Best Practices.
• Secure all required closing documents from the insured, claimant, lien holder or other parties as needed. This includes releases, dismissal entries, proofs of loss, etc.
• Ensure Claims payments are issued in a timely and accurate manner.
• Identify files with subrogation potential and refer files to Subrogation Representative for evaluation and pursuit of potential subrogation claim.
• Document file activity notes and prepare written reports and letters as required.

Qualifications

5-10+ years claims experience or equivalent combination of education and experience. High school diploma or equivalent required. A college degree is preferred, but we also value a strong mix of relevant work experience. Candidate with Occupational Accident experience a plus; experience managing bodily injury claims is preferred. Work experience in the P&C insurance industry.

Salary

Disclosure required under applicable state or municipality regulations : The expected salary range for this position is $75,000 to $90,000 and will be impacted by factors such as the successful candidate's skills, experience and working location, as well as the specific position's business line, scope and level. HUB International is proud to offer comprehensive benefit and total compensation packages which could include health / dental / vision / life / disability insurance, FSA, HSA and 401(k) accounts, paid-time-off benefits, and eligible bonuses, equity and commissions for some position.