Litigation Claims Adjuster
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Allstate Insurance Company has an exceptional career opportunity for a Litigation Claim Service Adjuster in Coconut Creek, FL!
This job is responsible for investigating the most complex, major, or specialized claims when an attorney is representing the injured party, which may include high limits, high dollar exposure, complex litigation, or significant customer issues. The individual handles highly complex uninsured or underinsured motorist (UM/UIM) claims, highly complex Commercial Property Liability (CPL) claims, extra-contractual liability claims, or specialized claims (e.g., business interruption, loss of income, E&O policies, etc.), and highly complex claims involved in litigation, arbitration or mediation, coordinating with legal counsel and participating in depositions, hearings, trial, or arbitrations. The individual takes recorded statements, resolves loss of use claims, makes payments to appropriate parties, and negotiates and settles bodily injury issues. The individual delivers compassionate service that is fast, fair, and easy, to ensure customer retention while verifying coverage, investigating and determining liability, and negotiating and settling highly complex claims. The individual provides work guidance and direction to less senior employees and provides mentoring and coaching to the team. The individual works independently, prioritizes the individual's own responsibilities, and manages the individual's own workload. The individual consistently meets band level behaviors, production, quality and/or customer service goals.
- Makes and maintains a connection with the customer by understanding and meeting their needs; serves the customer with empathy; and follows up to ensure that customer needs have been met
- Manages, researches, and resolves highly complex customer communications, concerns, conflicts or issues
- Reviews customer satisfaction results; recommends, designs, and implements personal and business unit action plans
File Documentation and Reporting
- Summarizes documents and enters into claim system notes
- Documents a claim file with notes, evaluations and decision making process
Coverage, Liability and Evaluation
- Determines and explains minimum coverage limits in highly complex claims involving single or multiple claimants
- Sets initial reserve, updates reserve, documents rationale and claim summary notes
- Obtains photos and/or conducts scene investigation
- Takes recorded statements from claimants, insureds, witnesses, medical providers, etc., conducts investigations into highly complex auto accidents, determines liability, and prepares summaries
- Evaluates and determines potential use of experts; reviews reports and selects the expert
- Determines claim value
- Reviews file to identify highly complex potential legal issues
Key Responsibilities (Cont'd)
Negotiation and Settlement Guidance
- Negotiates and settles claims in accordance with business unit best practices
- Reviews medical reports in preparation for claims settlement evaluation
Other Projects and Responsibilities
- May serve as a committee team lead or member for large, complex projects
- May participate in one or more highly complex special assignments
- May serve as a subrogation or arbitration panelist
- Frequently participates in special projects as a subject matter expert
- May participate in oversight activities
- Researches, responds to, or participates in Department of Insurance complaints or investigations
- Participates in or leads Telephone Alert Conferences regarding highly complex claims referred to Home Office
- Prepares referrals to home office
- Reviews highly complex files and makes recommendations to refer files to Home Office for escalation
- Researches and responds to or resolves highly complex compliance issues
- May serve as a team lead or fill in for the FPL as needed
- May lead roundtable and/or calibration discussions
- Leads training sessions
- Bachelors degree in related field preferred or equivalent experience
- Ability to interact effectively, and coach others on interacting effectively, with internal or external customers and act with empathy
- Applies highly advanced knowledge of insurance policy, coverage, and regulation
- Applies advanced knowledge of claim processes, policies, procedures, claim systems, coverage, liability, damage estimating, and/or settlement, and adherence to applicable legal compliance standards
- Applies advanced industry knowledge to discipline practices, including best practices, to support the business unit
- Applies advanced knowledge of analytical procedures to reconcile, manipulate, and recognize patterns of data
- Applies highly advanced knowledge of problem solving and preparation of complex reports for analysis
- Applies highly advanced ability to leverage learned technical skills in support of team objectives
- Applies highly advanced negotiation and/or arbitration skills
- Applies highly advanced conflict management and problem resolution skills in managing internal and external customer relationships
- Applies highly advanced problem solving skills to continuously improve business outcomes
- Ability to assist leadership in achieving business unit objectives
- Applies highly advanced knowledge of training facilitation and coaching skills
- Ability to investigate, evaluate and settle highly complex claims
- Provides highly advanced individual decision making within authority limits
- Works within highly complex assignments requiring specialized knowledge in breadth and/or depth in area of expertise
- Has and maintains all appropriate licenses and registrations for the role per state requirements
The candidate(s) offered this position will be required to submit to a background investigation, which includes a drug screen.
Good Work. Good Life. Good Hands.
As a Fortune 100 company and industry leader, we provide a competitive salary but thats just the beginning. Our Total Rewards package also offers benefits like tuition assistance, medical and dental insurance, as well as a robust pension and 401(k). Plus, youll have access to a wide variety of programs to help you balance your work and personal life -- including a generous paid time off policy.
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Allstate generally does not sponsor individuals for employment-based visas for this position.
Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component.
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