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PIP Telephone Claims Representative I

Company: National General Insurance
Location: Laredo
Posted on: August 6, 2019

Job Description:

PRIMARY PURPOSE:Examine claims data, investigate the facts of loss, determine coverage and liability, and adjusts claims within limit of authority.----ESSENTIAL DUTIES AND RESPONSIBILITIES:Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.- Establish an investigative plan; initiate investigation by gathering facts and evidence with all interested parties; complete appropriate reports; take recorded statements when necessary, may review loss reserves and adjust or opens hidden exposures as necessary- Evaluate and adjust claims within limit of authority and summarize claims in excess of authority and submit to manager for approval- Evaluate settlement alternatives by reviewing regulatory compliance and fair claims practices; make decisions on best option- Make appropriate contacts to discuss a settlement; extend an offer to appropriate party; document all file activity and payment/settlement information in file notes clearly outlining basis for settlement- Determine subrogation or fraud potential and refer to Unit when potential exists or handle to conclusion- Identify customer needs and work to meet those needs using appropriate customer service skills- Develop an understanding of the functions of other departments, such as Policy Ops and Marketing--_Trainee_- Shadow and learn the above stated essential duties and responsibilities- Learn to handle most aspects of auto claims- Develop a basic understanding of the content of policies written by the company- Develop a basic understanding of the insurance industry and the organizational relationships of the company- Learn how to determine subrogation or fraud potential and how to handle- Develop a basic understanding of systems and technology used within the company--_Level I_- Receive claim assignments and verify/investigate coverage and document all appropriate information before Manager is involved with review of claims to ensure they are commensurate with ability- May handle more complex files with appropriate supervision to develop skills- Develop a working knowledge of systems and technology used within the company

Keywords: National General Insurance, Laredo , PIP Telephone Claims Representative I, Other , Laredo, Texas

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