What are the responsibilities and job description for the Property Claims Specialist position at EMC Insurance Companies?
At EMC, you'll put your skills to good use as an important member of our team. You can count on gaining valuable experience while contributing to the company's success. EMC strives to hire and retain the best people by engaging, developing and rewarding employees.
This position is eligible to work from home in Central and Eastern Region states
Essential Functions :
Promptly investigates and evaluates large and complex commercial property claims across multiple states and reinsured cyber claims as assigned :
Reviews and evaluates the claim notice, lawsuits, contracts, state statutes, and policies to verify the appropriate coverage, deductibles, claim payee / mortgagees, and determines compensability
Performs field inspections on large and complex commercial property claims as applicable
Collaborates with independent adjusters or Large Loss Specialists as necessary on large and complex claims as needed
Initiates timely contact with customers and thoroughly explains the claim process
Organizes appropriate experts to ensure urgent matters are addressed, such as initial remediation, temporary restoration, business continuation either at the damaged location or at a new temporary business site, preserving evidence, securing origin and cause experts, various engineers, general and subcontractors etc., and multi-party reinspection
Obtains statements from insureds, claimants, witnesses, and all other pertinent parties
Documents claims activities, reserve analysis, summaries of reports in the claim system
Coordinates the prompt replacement and / or repair of damaged property with vendor services, such as contractors, emergency repair, remediation, and demolition when appropriate
Recommends the use of appropriate experts, such as general contractors, certified public accountants, engineers, or cause and origin experts, to assist in evaluation and adjustment of loss, and coordinates work with experts as approved
Completes thorough analysis of pertinent facts and sets and maintains timely, adequate reserves in accordance with the company reserving philosophy and methodology to cover company exposure
Re-evaluates claim as new facts are identified through the investigation and repair process
Analyzes business records, such as profit and loss statements, tax forms, financial forecasts, and payroll records to estimate the loss of business income
Selects forensic accountant for uncommon exposures when necessary
Secures all necessary official reports, claim forms, and pertinent documents
Reviews bills, invoices, and receipts, including legal and litigation related expenses, for accuracy and appropriateness
Notifies all parties involved that legally require appropriate notice
Notifies the Claims Supervisor of claims which require assignment to more senior level team member
Negotiates, settles and / or resolves large and complex commercial property claims across multiple states :
Resolves questions of coverage and resolves disputes on repair methods and the value of the claims
Evaluates cause of loss and writes detailed estimates for cost of repairs and value of damaged property, including reviewing discrepancies identified
Drafts and sends reservation of rights and denial letters upon manager approval
Communicates with insureds / claimants / attorneys to negotiate the settlement of claims
Identifies potential fraudulent claims and refers cases to Special Investigation Unit (SIU) as necessary, participating in any subsequent subrogation and SIU proceedings
Drafts and issues settlement documents and timely payments, including Statements of Loss and Proof of Loss, and verifies accuracy and compliant documentation
Assists as needed in the coordination and preparation of cases involved in mediations, appraisals, arbitrations, and lawsuits
Collaborates with impacted departments :
Submits referrals to the Estimatics, SIU, Large Loss Claims, Bond, Subrogation, and Coverage Counsel as appropriate
Prepares risk reports for Underwriting and Risk Improvement
Reviews coverage intent and policy activity with Underwriting
Reviews account inspection information with Risk Improvement
Handles referrals of property or property damage claims from other units or departments
Reviews and audits property estimates written by independent adjusters and contractors for accuracy and the most cost-effective repair approach
Acts as a technical resource for less experienced property claims team members. Provides guidance to team members with technical estimating issues of a claim and answers questions on coverage, procedure, and repair techniques
Participates in projects as necessary
Education & Experience :
Bachelor’s degree or equivalent relevant experience
Eight years of property claims adjusting experience or related experience
Relevant insurance designations preferred
Knowledge, Skills & Abilities :
Exceptional knowledge of best claims practices used to resolve the most serious and complex property claims
Excellent knowledge of commercial insurance contracts and procedural laws
Excellent knowledge of computers and claims systems
Ability to obtain all applicable state licenses
Exceptional organizational and empathetic interpersonal skills
Exceptional written and verbal communication skills
Thorough investigative and problem-solving abilities
Ability to maintain confidentiality
Occasional travel may be required; a valid driver’s license with an acceptable motor vehicle report per company standards required if driving
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