Principle Duties and Responsibilities:
Under general supervision, is accountable for the investigation and settlement of all classes of property claims as assigned by Claims Management. Also responsible for initiating action to report, investigate, and settle claims not yet reported to Claims Management that are encountered while working in the field. Responsibility includes examining agent’s policy records, claim assignment data, and all pertinent information to determine policy status and coverage. Notify Claims Department of any reserves that need to be modified. Initiate action to receive claim assignments via electronic media on a daily basis. Take action to contact insured and complete assignment in accordance with company’s provisions and comply with regulations of the Company's Claims Best Practices Manual and Texas Department Insurance Code.
Investigate all assigned claims through personal, telephone and written correspondence with insured(s), witnesses, professional experts, law enforcement, governmental agencies, attorneys, and others. The required field investigations are conducted to prepare the claims for disposition including taking of statements, estimating property or physical damage and securing all pertinent information available.
Develop files that accurately and thoroughly document claim information for particular files within the policy and procedural guidelines established by management.
Negotiate fair settlements based on investigation, experience and judgment. Use good interpersonal and communication skills in all contact with policyholders. Maintain equanimity during stressful situations. Conduct oneself in a professional manner by adhering to the company’s guidelines of dress and conduct described in the employee manual.
Prepare reports, estimates, properly identify photographs, write checks, draw diagrams, write letters, expense and mileage reports, employee benefit documents and all other required documents or correspondence in a prompt and timely manner. Maintain adequate expense control by adhering to company’s purchasing guidelines and departmental rules. Maintain consistent and timely oral and written communication with the appropriate Claims Supervisor on special claims.
Is alert to possible fraudulent claims and performs fair and impartial in-depth investigations of all suspected fraud cases. Diligently develop documents and validate all relevant facts. Interview insured(s), third parties, witnesses, friends, neighbors, law officials, business associates, and other possible sources of information. In some cases, it will be necessary to research lien holders, other liens, tax records, judgments, bankruptcies and other pertinent records in county and district court records. Prepare detailed, complete, written reports to thoroughly document all known relevant facts regarding suspected fraudulent claims, while maintaining non-slanderous conversation or non-libelous correspondence during the investigation and reporting.
Assist and advise independent contracted adjusters on matters involving policy interpretation, claims procedures, underwriting procedures, inspection of property and Unfair Claims Practices Act. Employ, on a contractual basis, contractors, forensic experts, engineers, and attorneys to assist on claims assignments.
Promote goodwill and ethical conduct with agents and fellow employees.
Perform other duties as assigned.
1. Bachelor’s degree from an accredited college or university preferred.
2. Two years prior property claims experience or completed Adjuster Trainee program.
3. All-Lines or Property & Casualty Adjuster License issued by the Texas Department of Insurance.
4. Must possess a valid Texas Drivers License and acceptable motor violation report.
5. Must possess knowledge and prior use of personal computers and common business software (word processing, spreadsheet, operating software)
6. Must demonstrate ability to learn policy coverage, investigative techniques, legal principles, and evaluation of damages and construction terminology.
7. Must demonstrate good communication skills and the ability to listen.
8. Must demonstrate good telephone and personal etiquette.
9. Must be bondable.
10. Ability to climb steep, high roofs, maneuvers around in attics and crawl spaces, and endures strenuous physical activity on an occasional basis.
11. Must be willing to travel extensively.
12. Must demonstrate ability to effectively work with others by:
a. Accepting constructive criticism with a positive attitude.
b. Remain emotionally stable under conditions of stress.
c. Avoid argumentative encounters.
d. Admit mistakes.
e. Adapt easily to new work instructions.
f. Use time effectively.
TITLE: Property Claims Representative(Field)
Investigate and settle property claims involving Homeowner policies, Texas Dwelling policies, Texas Business Owners policies, Commercial Fire Policies, for company Farm Mutual Dwelling Policies, and Church and Organizational policies.
TYPICAL WORK CONDITIONS:
Daily automobile travel; overnight travel for several nights at a time; Inside and outside work in uncomfortable weather conditions; requires after hours work on a regular basis;
And overnight travel on a periodic basis. Physical activity includes climbing on ladders, ability to climb up steep roof inclines, withstand heights, inspect attics, and go beneath dwellings.
Automobile, camera equipment, office equipment, ladders, measuring devices & personal computers
KNOWLEDGE/TRAINING: Knowledge of Personal Computers and ability to use estimating, spreadsheet, database, word processing and communication software and use the peripheral equipment; Knowledge of Homeowners Policies, Texas Dwelling Policies, Commercial Fire Policy, and Texas Business Owners Policy, Texas Department of Insurance rules and regulations, Insurance law; Type IV Adjuster’s license
Communicate daily with home office, Property Claims Supervisor, insured, agents, and vendors via electronic media, telephone, facsimile, and mail. Schedule appointments. Meet with policy holders, inspect damage, write estimates, write reports, and negotiate claim settlements.