ESIS, Claims Associate

JOB DESCRIPTION

ESIS Claim Associate, Tampa, Florida

Key Objective:

Under the direction of the Claims Team Leader investigates and settles claims promptly, equitably and within established best practices guidelines.

Duties may include but are not limited to:


* Receive new assignments.


* Reviews claim and policy information to provide background for investigation and may determine the extent of the policy's obligation to the insured depending on the line of business.


* Contacts, interviews and obtains statements (recorded or in person) from insured's, claimants, witnesses, physicians, attorneys, police officers, etc.

to secure necessary claim information.


* Arrange for surveys and experts where appropriate.


* Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extend of the company's obligation to the insured under the policy contract.


* Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc.


* Sets reserves within authority limits and recommends reserve changes to Team Leader.


* Reviews progress and status of claims with Team Leader and discusses problems and suggested remedial actions.


* Timely and appropriate management of litigation files.


* Assists Team Leader in developing methods and improvements for handling claims.


* Settles claims promptly and equitably.


* Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims and expenses.


* Informs claimants, insured's/customers/ agents or attorney of denial of claim when applicable.


* May assist Team Leader and company attorneys in preparing cases for trial by arranging for attendance of witnesses and taking statements.

Continues efforts to settle claims before trial.


* Refers claims to subrogation as appropriate.


* May participate in claim file reviews and audits with customer/insured and broker.


* Administers benefits timely and appropriately.

Maintains control of claim's resolution process to minimize current exposure and future risks


* Establishes and maintains strong customer relations i.e.

agents, underwriters, insureds, experts

Depending on line of business, other duties may include:


* Maintaining system logs


* Investigating compensability and benefit entitlement


* Reviewing and approving medical bill payments or forwarding for outside review as necessary.


* Managing vocational rehabilitation

SCOPE INFORMATION:

The position reports directly to a Claims Team Leader or other member of claims management.

QUALIFICATIONS



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ABOUT US

Chubb is a world leader in insurance.

With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients.

The company...