Claim Representative Responsibilities and Duties

Investigate claims and obtain relevant facts to determine coverage, loss and liability.

Interact effectively with customers, insurance agents, police, attorney and other public personnel involved in claim process.

Assist Supervisor in analyzing, planning, decision-making and problem-solving activities to support claim settlement.

Oversee legal and medical aspects of claims.

Document claim file activities in accurate and timely manner.

Resolve claim issues promptly and follow-up on outstanding issues.

Perform negotiation with insured and claimant to achieve claim settlements.

Communicate claim status to supervisor and customers on regular basis.

Contact outside agents for claim investigation if needed.

Recommend claim and expense reserves

Obtain state licenses as required.

Work in compliance with state regulations and applicable jurisdictions.

Perform claim assignments received from Supervisor in timely and accurate manner.

Work under the guidance and assistance of Supervisor to ensure accurate claim settlement.

Manage claim settlements within authority limits.

Attend educational workshops on claim filings.

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