American Family Insurance - Corporate Complex Property Claims Field Adjuster (Glendale, CA) in Glendale, California
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R19280 Complex Property Claims Field Adjuster (Glendale, CA) (Open)
This position will focus on Large Loss adjusting necessitating travel to states in our operating territory to assist in Large Losses or for CAT situations. This is a work from home position with company car.
The Property Claim Large Loss Adjuster position supports the Claim Division goal of ensuring customer service industry leadership and partners with agency to deliver seamless claim service. An experienced Property Claim Field Large Loss Adjuster has achieved mastery in and performs all areas of property claim adjustment activities with the highest degree of competency and independence. Processes high exposure and complex property field claims that require on-site inspection on a routine basis. Evidences effective performance in the areas of customer, agency and public relations; and is active and competent in conducting training of new claim personnel. Serves as subject matter expert providing support in strategically addressing complex files in coordination with internal business partners and industry experts. Manages all aspects of claims process from damage identification, expert utilization including but not limited to: Origin and Cause Experts, Engineers, Forensic Accountants, SIU Investigator, Fire Marshall, Police Department, contractors, personal property experts, Legal Counsel, Department of Insurance Employees, and Public Adjusters.
Estimating Loss & Damages (25%)
Gathers information via on-site inspections and research to determine replacement costs across all coverages
Prepares accurate estimates utilizing electronic estimating tools, replacement research results, appraisals, arbitration, reconstruction consultants and contractor data to establish fair and competitive pricing within Fair Claims Acts
Completes factual reports within claim authority in coordination with management by recommending settlement values for large and complex claims as outlined in company policies & procedures and state regulations
Maintains and projects reserves by controlling dwelling, personal property and additional living expense exposures and expenses
Coordinates with management, business partners, and industry experts handling complex losses up to policy limits
•Provides testimony and deposition statements to participate in the litigation and discovery process.
Large Loss Claim Investigation (25%)
Investigates cause and origin by contacting the appropriate parties including insureds, claimants, agents, attorneys, contractors, vendors, other adjusters, and public personnel
Coordinates with experts to assist with complex issues such as court interpretations, structural design, and mold. Position requires close connectivity and partnering with Legal, company personnel internal business partners, and experts, e.g. engineers
Recognizes pertinent issues and formats questions to obtain recorded or written statements to resolve assigned claims.
Recognizes when to secure public documents to complete a claim file investigation; secures, preserves, and maintains evidence in a legal manner.
Recognizes and investigates losses involving subrogation and salvage potential. Uses knowledge of third-party and tort liability.
Investigates and handles complex fraud files. Involves and coordinates investigation with SIU (Special Investigations Unit) when necessary.
Interprets claim history coverages. Selects proper loss codes based on policy type. Identifies state-specific legislation and legal precedent based on prior legal cases for assigned geographical area; seeks assistance as needed.
Demonstrates knowledge of underwriting guidelines; inspects risks and makes recommendations to the Underwriting Department as needed.
Applies decision-making process to determine extent of coverage or non-coverage and communicates results to appropriate parties.
Complies with Unfair Claim Practices Acts and handles claims in good faith. Adheres to Corporate Guidelines, Company Claim Bulletins, and the Company Code of Ethics
Claim File Administration and Large Loss Management (25%)
Actively manages individual claim inventory and works toward meeting cycle-time goals for closing files. Claim inventory will focus on highly complex claims that require on-site inspection and face-to-face contact with customers utilizing a mobile office when appropriate. These claims include but are not limited to structural damage, smoke, water, tornado, fire and total losses that require extensive investigation due to complex coverage issues, fraud indicators, and involvement of public adjusters or that require specialty vendors (engineers, forensic accountants, legal experts, subrogation teams, law enforcement, etc.)
Utilizes the claim system to complete and document actions throughout the entirety of the claim process.
Conducts initial review of claims received to identify prior actions taken (e.g. services provided by the Customer Care Center and appointments scheduled) and determines next steps.
Contributes to the team environment and engagement by assisting with peer inventories during absences. Responds to customer inquiries, makes appropriate decisions, and closes file as needed.
Maintains a global view of the property claim workflow in order to provide customers with appropriate, accurate, and timely information.
Completes and presents High Damage Review summaries to leadership and HDR advisor within communicated timelines.
Negotiation and Claim Settlement (15%)
Handles claim negotiations by settling and providing the best-in-class customer experience.
Clearly and accurately conveys all settlement activities involving scope, estimating, and coverage to the insured or their representatives.
Works professionally and negotiates with multiple parties including insureds, contractors, or insureds representatives. Conveys claim settlements within authority limits.
Recognizes the need for and obtains non-waiver as needed. Recognizes the need for and sends Reservation of Rights letters and other coverage and correspondence.
Recognizes, controls, and resolves disputes with tact and diplomacy.
Utilizes company vendor programs to assist in the accurate settlement of losses
Notifies or directly involves the agent in dispute resolution. Utilizes arbitration, appraisal, and alternate dispute resolution to settle losses
Handles and negotiates all claims on a good faith basis.
Agency Relationship (10%)
Establishes rapport with agents and builds on-going relationships.
Partners with agency to provide seamless customer service. Jointly identifies opportunities for process improvements and establishes and implements action plans to address them.
Facilitates communication between customers, agents, vendors, third party administrators and other employees. Proactively provides agents with important claim related information and provides all parties with claim process and status as appropriate, as well as answers questions or redirects to other areas.
Provides agents with claim handling information and problem resolution via phone conversations, office visits, or presentations at district meetings
Must be willing to travel for Catastrophe and severity based duty when necessary
This position requires travel up to 75% of the time
This position requires the ability to work in high, precarious places between 1 and 33% of the time
This position requires the ability to work with exposure to outside weather conditions between 66 and 100% of the time
This position requires the ability to climb or balance between 1 and 33% of the time
This position requires the ability to work with distance vision (clear vision at 20 feet or more) for extended periods (applies to field position only)
This position requires the ability to stoop, kneel, crouch, or crawl between 1 and 33% of the time
This position requires the ability to lift up to 50 pounds between 33 and 66% of the time (applies to field position only)
Specialized Knowledge and Skills Requirements:
Demonstrated experience providing customer-driven solutions, support or service
Demonstrated ability to efficiently and effectively handle the highly complex property claims
Extensive knowledge and skill related to each phase of the property claim handling process
Flexibility to work nontraditional hours including disaster claim duty per customer needs. CAT pay is eligible in certain instances per company guidelines
Demonstrated organization and time management skills with the ability to work under pressure and adhere company productivity guidelines
Demonstrated multi-state claims handling experience and licensing with an understanding of state specific guidelines
Valid driver's license required plus an acceptable driving record
Additional Job Information:
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