Associate Pip Claim Representative

3 weeks ago


Hastings, United States Hastings Mutual Insurance Company Full time

Hastings Mutual is currently looking for an Associate Claim Representative As a member of our Personal Injury Protection (PIP) Claim Team, this role will provide effective claim processing and adjusting support for our policyholders. This is a great junior-level opportunity for individuals with a background in customer service or support. Prior insurance experience is helpful, but not required

**Position Overview**:
The individual in this role investigates, evaluates, negotiates, and resolves PIP claims through effective research, negotiation, and interaction with policyholders, claimants, and agents in accordance with the Company’s contractual and legal obligations while providing an outstanding customer experience.

**Position Location & Work Format**:
**Position Duties & Responsibilities**:

- Manages a pending inventory of claims and ensures they are properly adjudicated to resolution.
- Handle low complexity Personal Auto and Commercial Auto Personal Injury Protection (PIP) and MedPay Claims.
- Complies with all state and federal regulations, Core Values, and established processes and guidelines.
- Facilitates the claim process and resolves claims in a timely manner by initiating and maintaining positive and productive communications with agents, claimants, and policyholders.
- Contact policyholders, claimants, and witnesses to complete a thorough investigation of the loss facts.
- Work with injured parties, medical providers, and attorneys to facilitate appropriate medical care.
- Appropriately reviews and applies coverage/compensability for all claims.
- Investigates, evaluates, and settles claims within the scope of the Company’s contractual and legal obligations to ensure that settlements are fair and equitable to the insured, claimant, and the Company
- Determine coverage by reviewing loss details and applicable policy language.
- Complete the investigation by obtaining police reports, recorded statements, and other related documents.
- Manage claims to timely resolution.
- Ensures salvage and subrogation opportunities are identified and pursued in order to minimize claim losses.
- Utilizes all appropriate loss and expense savings programs and directs the activities of outside vendors to ensure only necessary and cost-effective work is accomplished
- Use outside vendors only when necessary and with prior supervisor approval.
- Accurately and thoroughly documents all claim files in the Claim system of record to substantiate the disposition of the claim and minimize the possibility of erroneous payments.
- Establishes and maintains appropriate case reserves sufficient to fund the payment of the claim once it is resolved whether through settlement, litigation, or arbitration.
- Identifies potential fraud and refers to the appropriate authority.
- Interacts with outside experts such as surveillance companies, independent adjusters, and special investigators.
- Coordinates relevant claim information with Loss Control, Underwriting, Marketing, etc., to maximize the Company’s effectiveness.
- Actively participates in professional development, i.e. continuing education or self-improvement.
- Other duties as assigned by leadership, either verbally or in writing.
- Bachelor’s degree is preferred or equivalent work experience.
- Demonstrated PC skills including proficient use of Microsoft Office products.
- Demonstrated excellent verbal, written, and interpersonal communication skills.
- Ability to work independently and cultivate an environment of teamwork.
- Demonstrated customer service skills.
- Demonstrated critical thinking skills and the ability to be decisive.
- Ability to effectively manage conflict.
- Good time management and organizational skills with the ability to prioritize and complete work and/or projects effectively.

**Our Commitment as an Employer**:
**About Hastings Mutual Insurance Company**:
From our humble roots in 1885 providing coverage for windstorm damage, Hastings Mutual has evolved into a leading regional property and casualty insurance carrier, offering innovative products for businesses, farm owners, and individuals. We work with customers in six Midwestern states (Illinois, Indiana, Iowa, Michigan, Ohio, and Wisconsin). Hastings Mutual is known for its financial strength, high ethical standards, and culture of service and responsiveness.

The core of our ongoing success is our employees. Whether at the corporate offices in Hastings, Michigan to our remote team members throughout the Midwest, Hastings Mutual is made up of talented professionals across multiple divisions and functional areas. Our commitment to our employees and work culture has been confirmed with our inclusion in the “Best and Brightest Companies to Work for in West Michigan” each year since 2011.

Hastings Mutual offers a friendly, family-like environment that values transparency and approachability. We recognize the hard work of our employees with many benefits, including fully paid certificati


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