Personal Lines Claims Professional
2 months ago
We are seeking a highly skilled and experienced Senior Claims Representative to join our team at Plymouth Rock Assurance. As a Senior Claims Representative, you will be responsible for handling complex First and Third Party Bodily Injury claims in a Personal Lines/Commercial environment.
Key Responsibilities- Initiate prompt contact with insureds, claimants, and witnesses to conduct thorough coverage and liability/injury investigations.
- Analyze, review, and interpret policies to assess coverage and liability, providing advice on excess and primary coverage issues.
- Conduct field investigations, interviews with insureds, witnesses, and claimants, while maintaining a pending of represented and unrepresented claimant cases.
- Manage and direct outside vendors to determine necessary investigation and provide direction to bring a claim to conclusion, ensuring only necessary work is completed.
- Investigate cases timely to establish and maintain proper reserve levels, revising reserves timely based on developments in the course of the claim.
- Investigate the validity of bodily injury claims presented by individual insureds, claimants, or attorneys representing insureds/claimants, being aware of potential fraudulent claims and referring to SIU for investigation.
- Handle complex claims, including coverage issues, UM/UIM, TNC, Commercial, Umbrella, and prior litigation handling.
- Recognize and investigate subrogation potential.
- Negotiate both 1st and 3rd party claims directly with injured parties and/or their attorneys.
- Exercise proper judgment and decision-making to analyze exposure, determine the proper course of action, and make recommendations for final resolution.
- Attend litigation proceedings to represent the company or participate in arbitrations, depositions, settlement conferences, mediations, and trials.
- Participate in proactive team activities to achieve departmental and company objectives, may be asked to participate in special projects, committees, or assignments from management.
- Utilize claims systems, Excel, Word, and social media search engines.
- Prepare case summaries for significant reserve increases and/or trial alerts, participate in roundtable discussions.
- Effectively manage workload while maintaining diary and focus on claims quality.
- Possess knowledge of and adherence to State(s) laws and regulatory claim handling guidelines and statutory regulations.
- Adhere to departmental internal control requirements, comply with Plymouth Rock's standards, best practices, and ethical guidelines, adhere to Plymouth Rock's culture.
- A bachelor's degree (B.A.) from an accredited four-year college or university.
- 5-10 years' experience handling liability commercial, homeowners, UM/UIM, Excess/Umbrella.
- In-depth knowledge of litigation, arbitration, and trial process, handle out-of-state claims, and/or Personal Injury Protection claims.
- Currently holds and/or can readily obtain an out-of-state license(s). Professional designation such as IIA, AEI, Senior Claim Law Associate (SCLA) or Chartered Property Casualty Underwriting (CPCU) or be actively working towards a designation, preferred.
- High level of self-motivation.
- Advanced skills in coverage, investigation, litigation/legal issues, negotiations, evaluations, medical terminology, and subrogation.
- Strong communication, organizational, customer service, and time management skills.
- Excellent problem-solving skills.
- Possess knowledge of and adherence to State(s) laws and regulatory claim handling guidelines and statutory regulations.
Plymouth Rock Assurance and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of 'A-/Excellent'.
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