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- Request medical records/bills for independent review.
- Contact the claimant's PIP carrier to verify coverage and benefits paid. Take statements on coverage issues; notifies Underwriting of any problems. Confirms either insufficient coverage or no coverage on tortfeasor.
- Evaluates claimed injuries; identifies strong and weak points of both claimant's and insured's position.
- Review PD/collision photographs.
- Keeps track of required correspondence and reviews files.
- Sends excess letters to insured (s) on serious injury and multiple competing claims.
- Negotiates settlements with either attorney or unrepresented claimant; identifies and notes any lien holders against settlement.
- Keeps insureds advised of developments in claims and settlements. Reserving the Company's rights, when appropriate.
- Upon settlement, prepares and sends release and hold harmless documents.
- Evaluate claims for potential fraud and work with Special Investigations Unit as required.
- Assess actual damages associated with claims and conduct negotiations to settle claims.
- Determine if subrogation exists and take steps necessary to initiate recovery efforts.
- Determine the need for independent adjusters, cause and origin experts, independent medical examiners, economists, accident "reconstructionist", and engineers.
- Respond timely and appropriately to all settlement demands.
- Keep internal and external customers advised of file status and other matters as required.
- Proficiently handle first reports of Bodily Injury claims.
- Accurate recognition of other relevant claims exposures.
- Identify and present files that need further review with management.
- Associate or bachelor's degree preferred and/or 5 years of related work experience, preferably with bodily injury claims.
- Active Adjuster's license
- Bilingual (English & Spanish)
- Non-standard auto industry experience is a plus.
- Proficient in Word, Excel, Windows-based applications, and internet usage.
- Guidewire knowledge preferred.
- Must be familiar with forms, procedures, regulations, coverages, and business processes.
- Must be able to exercise good judgment and state opinions assertively.
- Must be able to write and speak clearly and concisely.
- Must be able to perform work effectively in a highly intense environment and handle multiple tasks and demands simultaneously.
- Must illustrate analytical skills to identify, gather, and organize information.
- Must be able to work independently in a team environment.
- 401(k) Retirement Savings Plan with employer match.
- Comprehensive Medical, Prescription Drug, Vision, and Dental Insurance
- Paid Time Off, Holidays, and Leave programs.
- Flexible spending accounts
- Basic Life Insurance and Voluntary Life/ADD
- Voluntary Short Term and Long-Term Disability
complex adjuster - Miami, United States - United Auto Insurance
Description
COMPANY OVERVIEW:Founded in 1989, United Automobile Insurance Company is an innovative and established organization looking for Complex Bodily Injury Adjuster(s) to join our team. Family-owned, UAIC, is one of the largest privately held property and casualty insurance companies in the United States. The key to our growth and success is a commitment to providing quality service to our agents and customers, by providing disciplined underwriting, and strategic claims handling. Our ongoing efforts to invest substantial resources in personnel and technology are the foundation of our promise of assuring maximum efficiency and specialized operations in the industry. We are proud that our independent agents and customers have recognized our dedication by making UAIC the market leader in every state where we conduct business.
SCOPE:
As a Complex Bodily Injury Adjuster, you will be responsible for the investigation, evaluation, negotiation, disposition, and settlement of auto liability claims, to determine legal liability, damages, and coverage. This position requires thorough and complete investigations to gather sufficient information to make informed and knowledgeable coverage and liability decisions. Assigned claims will involve severe and/or catastrophic injuries and/or damages including higher limits of coverage, requiring direct involvement in handling complex issues and high-exposure events, with minimal supervision. Exceptional evaluation and judgment skills are required to develop all potential exposures in the file and to properly set indemnity reserves. The protection of our Insured and the Company's financial exposures are critical. This position offers a remote work arrangement, allowing the ideal candidate to work from their preferred location within the Southeast region.
DUTIES:
UAIC is an Equal Opportunity Employer and is committed to the principle of equal employment opportunity for all employees. All employment decisions at UAIC are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion, or belief, family or parental status, or any other status protected by the laws or regulations in the locations where we operate.