Claim Adjuster, Auto Bodily Injury

2 weeks 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. Promptly manage ABI 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 severe ABI claims.
- Consult with Manager on use of Claim Coverage Counsel as needed.
- Directly investigate each ABI 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 Subro, Risk Control, nurse consultants, fraud investigators, and other experts.
- Verify the nature and extent of injury or damage by obtaining and reviewing appropriate records and damages documentation.
- Maintain ABI 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 ABI claims with insureds 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, 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.
- 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 professionals to increase the technical expertise and improve bench strength.
- Share accountability with business partners to achieve and sustain quality results.
- Evaluate all claims for recovery potential; directly handle recovery efforts and/or engage and direct Company resources for recovery efforts.
- Perform other duties as assigned.
- University/College degree or equivalent in business experience preferred.
- Advanced level knowledge and skill in claim and litigation.
- Basic working level knowledge and skill in various business line products.
- Strong negotiation and customer service skills.
- Extensive claim and/or legal exper

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