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Job Details


Combined Insurance Company of America

Claim Specialist (340987)

Equipment/Technology Specialist

Equipment and Facilities Specialist

Yearly

No

Alpharetta, Georgia, United States

The Claim Specialist, under moderate direction from the manager, investigates and settles claims promptly, equitably, and within established best practices guidelines.

Scope

  • Responsible for investigating; settling high exposure, high risk Employment Practices Claims.
  • Insure high level of customer service and claim file quality.
  • Identifying and evaluating coverage issues, preparing comprehensive coverage letters and analysis, retaining and managing coverage counsel through trial, and developing and managing strategy for complex coverage litigation.
  • Evaluating exposure through an in-depth analysis of legal and factual issues, retaining and managing litigation counsel through trial, developing and managing strategy for complex litigation.
  • Attending arbitrations, mediations, trials.
  • Developing resolution strategies and negotiating settlements.
  • Reviewing legal budgets and legal and third-party vendor’s bills.
  • Presenting litigation strategy for complex litigation to senior claims management and underwriting staff.
  • Support business leaders on an as needed basis on various claim and underwriting related issues and marketing meetings.

Responsibilities

Duties may include, but are not limited to:

  • Day to day handling of substantial caseload of line of business claims.
  • Confirms coverage of claims by reviewing policies and documents submitted in support of claims.
  • Analyzes coverage and communicates coverage positions, as warranted, under direction of supervisor and coverage unit.
  • Conducts, coordinates, and directs investigation into loss facts and extent of third-party damages.
  • Directs and monitors assignments to experts and underlying defense counsel.
  • Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure.
  • Sets reserves within authority or makes claim recommendations concerning reserve changes to supervisor.
  • Reports to reinsurers and facilitates the prompt collection of reinsurance on those matters where they are accountable.