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Auto Bodily Injury Claim Representative
Auto Bodily Injury Claim RepresentativeUSA Jobs • Diamond Bar, CA, US
Auto Bodily Injury Claim Representative

Auto Bodily Injury Claim Representative

USA Jobs • Diamond Bar, CA, US
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Claim Representative

Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.

This position is responsible for handling Personal and Business Insurance Auto Bodily Injury claims from the first notice of loss through resolution / settlement and payment process. This may include interpreting and applying laws and statutes for multiple state jurisdictions. Claim @types include moderate complexity Bodily Injury claims. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations.

Customer Contacts / Experience :

Delivers consistent service quality throughout the claim life cycle, including but not limited to prompt contact, explaining the process, setting expectations, on-going communication, follow-through and meeting commitments to achieve optimal outcome on every file. Fulfills specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC) instructions.

Coverage Analysis :

Reviews and analyzes coverage and applies policy conditions, provisions, exclusions and endorsements for moderate complexity Bodily Injury liability claims in assigned jurisdictions. Verifies the benefits available, the injured party's eligibility and the applicable limits. Addresses proper application of any deductibles, co-insurance, coverage limits, etc. Confirms priority of coverage (i.e. primary, secondary, concurrent) and takes into consideration issues such as Social Security, Workers Compensation or others relevant to the jurisdiction. Consults with Unit Manager on use of Claim Coverage Counsel.

Investigation / Evaluation :

Investigates each claim to obtain relevant facts necessary to determine coverage, the extent of liability, damages, and contribution potential with respect to the various coverages provided through prompt contact with appropriate parties (e.g. policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts). This may also include investigation of wage loss and essential services claims. Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation. Takes recorded statements as necessary. Utilizes evaluation documentation tools in accordance with department guidelines.

Identifies resources for specific activities required to properly investigate claims such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators and to other experts. Requests through Unit Manager and coordinate the results of their efforts and findings.

Recognizing cases based on severity protocols to be referred timely to next level claim professional or Major Case Unit.

Reserving :

Establishes timely and maintains appropriate claim and expense reserves. Manages file inventory and expense reserves by utilizing an effective diary system, documenting claim file activities in accordance with established procedures to resolve claim in a timely manner.

Negotiation / Resolution :

Determines settlement amounts, negotiates and conveys claim settlements within authority limits to claimants or their representatives. Recognizes and implements alternate means of resolution. As appropriate, writes denial letters, Reservation of Rights and other necessary correspondence to claimants.

Handles both unrepresented and attorney represented claims. May manage litigated claims on appropriately assigned cases. Develops litigation plan with staff or panel counsel, track and control legal expenses. May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.

In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.

Perform other duties as assigned.

Bachelor's Degree preferred.

2 years bodily injury liability claim handling experience preferred.

General knowledge and skill in claims handling and litigation.

Basic working level knowledge and skill in various business line products.

Preferred License and Certifications

Demonstrated ownership attitude and customer centric response to all assigned tasks

Demonstrated good organizational skills with the ability to prioritize and work independently

Attention to detail ensuring accuracy

Keyboard skills and Windows proficiency, including Excel and Word - Intermediate

Verbal and written communication skills - Intermediate

Analytical Thinking- Intermediate

Judgment / Decision Making- Intermediate

Negotiation- Intermediate

Insurance Contract Knowledge- Intermediate

Principles of Investigation- Intermediate

Value Determination- Intermediate

Settlement Techniques- Intermediate

Medical Knowledge- Intermediate

High School Degree or GED with a minimum of one year bodily injury liability claim handling experience or successful completion of Travelers Claim Representative training program is required.

Health Insurance : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.

Retirement : Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.

Paid Time Off : Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.

Wellness Program : The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.

Volunteer Encouragement : We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.

Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.

In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.

If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you.

Travelers reserves the right to fill this position at a level above or below the level included in this posting.

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Claim Representative • Diamond Bar, CA, US

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