ESIS Claims Associate, AGL

JOB DESCRIPTION

KEY OBJECTIVE:



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

MAJOR DUTIES & RESPONSIBILITIES:

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

QUALIFICATIONS

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 is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional f...