Property Complex Claims Lead Adjuster

2 months ago

Seville, United States ohio farmers insurance Full time

The Complex Claims Lead Adjuster works within significant limits and authority on highly complex claim assignments. The role determines coverage, investigates, analyzes, negotiates, and settles complex claims with high exposure while delivering quality customer service. The role is responsible for initial catastrophe claim response and on-site participation anywhere within the company's operating territory. The role oversees the maintenance and storage of special claims handling documents and develop strong business relationships. The role empowers and leads claims adjusters to achieve claims management excellence, directly handles the largest and most complex claims, serving as a technical consultant and subject matter expert to business partners. Investigates complex insurance claims, including coverage, liability, potential legal issues, damages, and exposure and resolves complex claims within assigned territory, monitors the progress of the case and ensures that the proper coverage exists for claims with high financial impact and visibility. Recognizes claim file exposures and escalates appropriately and identifies time sensitive matters and issues requiring escalation to senior claims adjusters. Delivers claims administration activities and handles claim matters or claims operations experience supporting complex claims within authority limits and in accordance with company procedures and guidelines. Maintains effective communication with claims staff, business partners, insureds, claimants, attorneys, other insurance companies, vendors, and public adjusters to ensure excellent customer service. Determines whether proper coverage exists for the type of complex claim assigned and investigates thoroughly to obtain relevant facts concerning all aspects of the claim, such as coverage, liability, legal climate, potential exposure, and damages, and makes decisions, where appropriate, on claim resolution. Determines the value of the damage through physical inspections, the use of appropriate tools, and other experts/consultants and obtains all necessary documentation to support claim evaluation. Maintains effective and ongoing communication with claims staff, internal and external business partners, insureds, claimants, agents, attorneys, other insurance companies, claims leadership, vendors/contractors, and public adjusters. Establishes and reviews proper reserves for each claim based upon thorough investigation, evaluation, and experience and completes appropriate reports so that the status of claim is clearly documented. Travels as often as needed including regular utilization of assigned fleet vehicle to cover assigned territory. May involve traveling on short notice or other daily driving duties as assigned regardless of location. 7+ years of Complex Claims handling experience. Bachelor's degree in Business Administration or related field and/or commensurate work experience. Valid driver's license and a driving record that conforms to company standards. Westfield celebrates diversity and is committed to inclusion. All qualified applicants receive consideration for employment without regard to race, color, sex, religion, national origin, age, sexual orientation, gender identity, disability, or status as a protected veteran.

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