Commercial Claim Representative

2 months ago

Oakville, Canada The Travelers Companies, Inc. Full time

- Who Are We?


- Solid reputation, passionate people and endless opportunities. That’s Travelers. Our superior financial strength and consistent record of strong operating returns mean security for our customers - and opportunities for our employees. You will find Travelers to be full of energy and a workplace in which you truly can make a difference.

- Job Category
Claim

- Target Openings
1


- What Is the Opportunity?


- Investigate, evaluate, reserve, negotiate and resolve assigned claims in accordance with Best Practices.

Provide quality claim handling and superior customer service on assigned claims while engaging in indemnity & expense management. This role is responsible for handling 1st and 3rd party Personal Insurance (Theft and Fire) and Business Insurance APD claims. The role handles a wide variety of causes of loss. In addition, the role applies policy, legislation and company guidelines to all claims to manage loss costs and customer relations and supports other business lines with auto related tasks and claim handling where overlap exists with policy coverages. This also includes claims handling nationally.

Promptly manage APD claims by completing essential functions including contact, investigation, damages development, evaluation, reserving, litigation management, and disposition.

Provides consulting and training resources, and serves as a contact and technical resource to the field and our business partners.

What Will You Do?

Directly handle assigned moderate to severe APD claims.

Consult with Manager on use of Claim Coverage Counsel as needed.

Directly investigate each APD claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Interview witnesses and stakeholders; take necessary statements, as strategically appropriate. Complete outside investigation as needed per case specifics.

Actively engage in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Towing and Storage, Salvage, Subro, Risk Control, nurse consultants, and fire or fraud investigators, and other experts.

Verify the nature and extent of injury or damage by obtaining and reviewing appropriate records and damages documentation.

Maintain APD claim files and document claim file activities in accordance with established procedures Utilize evaluation documentation tools in accordance with department guidelines.

Proactively review CFAs for adherence to quality standards and trend analysis.

Utilize diary management system to ensure that all claims are handled timely. At required time intervals, evaluate liability & damages exposure.

Establish and maintain proper indemnity & expense reserves.

Recommend appropriate cases for discussion at roundtable.

Attend and/or present at roundtables/ authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expense.

Actively and enthusiastically share experience and knowledge of creative resolution techniques to improve the claim results of others.

Develop and employ creative resolution strategies.

Responsible for prompt and proper disposition of all claims within delegated authority.

Negotiate disposition of APD claims with insureds, vendors and claimants or their legal representatives.

Recognize and implement alternate means of resolution.

Manages litigated claims. Develop litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers.

Track and control legal expenses to assure cost-effective resolution.

Effectively and efficiently manage both allocated and unallocated loss adjustment expenses.

Attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.

Update appropriate parties as needed, providing new facts as they become available, and their impact upon the liability analysis and settlement options.

Recognize cases, based on severity/complexity protocols and where claims occur in jurisdictions requiring an adjuster licence, that should be transferred to another level of claim professional and refer on a timely basis.

Appropriately deal with information that is considered personal and confidential.

Fulfill specific service commitments made to certain accounts, as outlined in Special

Account Communication (SAC) instructions, and inquires from agents and brokers. Also, reviews and responds to Auto Plus inquiries.

Represent the company as a technical resource, attend legal proceedings as needed, act within established professional guidelines as well as applicable laws.

Actively provide mentoring and coaching to less experienced claim professiona

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