What are the responsibilities and job description for the Claims Specialist position at Everest Insurance Chile?
Title: Claims Specialist Company: Everest Insurance Chile Job Category: Claims Job Description: Everest Compañía de Seguros Generales Chile S.A., a member of Everest Re Group, Ltd., has an opportunity for a professional (i.e., engineer, accountant, attorney), to join our Claims team in Santiago de Chile. This individual will handle and analyze mainstream and complex general insurance claims of all varieties, with special focus in property, financial lines, and liability claims. Responsibilities include but not limited to: Daily handling, analysis and resolution of claims notified to Everest Compañía de Seguros Generales S.A. Management of claim portfolio at all levels of the adjustment process, ensuring the correct reserving, technical analysis, settlement, and payment of claims. Monitoring reserve development of cases, and proper and timely update of reserves into the Claims System, ensuring appropriate reserves are registered at all times of the process. Keeping system updated with relevant claims communications, supporting documents, Preliminary Reports & FAR, payment and settlement/release documents. Preparation of Impugnation to the Final Adjustment Report (FAR), Observations to the Preliminary Report of Article 24 of DS 1055, analyzing and resolving coverage issues and preparing coverage position letters. Due drafting & handling of settlement/releases and revision of supporting payment documents, ensuring its proper signature as per policies, protocols and formalities defined. Daily assistance to insureds, brokers, Reinsurers & coinsurers on claim related matters. Monitoring adjustment actions and process, and legal adjustment terms as per SLA and applicable regulations, requesting further technical arguments and explanations when required and updated reports. Investigating, analyzing, and evaluating liability and damages. Evaluating, determining, and Monitoring trial development handled by panel counsel. Preparing case summary reports related to matters of significant reserve, involving new trends, trial activity, denial of coverage or contingencies, etc. Coordinating and monitoring recovery actions and salvage process, keeping the system updated. Working with underwriters to support policy construction and drafting, reporting policy contingencies, gaps, claim trends, data analysis, and risk assessments. Evaluation and definition of defense strategy on liability claims and monitoring of nominated counsel. Strict compliance of claim monetary and non-monetary authorizations. Strict compliance of Everest International Claims Standards and LCR, and all other internal guidelines. Strict compliance of Everest Macro Claims Process for Chile and all related guidelines. Collecting and monitoring payment from reinsurers and coinsurers & keep the system updated with actions & payment status. Monitoring and control of claim related costs & expenses. Developing and executing claim strategies as well as resolution strategies. Managing, directing and monitor outside counsel on claim related matters, such as coverage opinions, arbitrations, etc. Attending conferences and handling all necessary and relevant communications related to claims and complex matters with insureds, brokers, adjusters, experts, reinsurers & coinsurers, actuaries, underwriters, and vendors. Negotiating and resolving complex coverage issues as per claim authorities and guidelines. Monitoring relevant jurisprudence on Civil and Labor Cases. Performing similar work-related duties as assigned. Qualifications, Education & Experience: Professional title (preferably law, accountancy & engineer). If lawyer, due knowledge of litigation, arbitration, and trial process. 4 to 6 years of claims handling experience. Language: Advanced English, written and oral. Strong analytical and organizational skills. Excellent verbal and written communication skills. Strong negotiation and investigation skills. Ability to think strategically. Ability to work under pressure. Ability to adapt to changes. Ability to work with a Team. Ability to identify and use relevant data and metrics to best manage claims. Collaborative mind-set and willingness to work with a Team. Ability and willingness to present to claims management and other members of the Company claim related topics. Knowledge of the insurance industry claims process, applicable regulations, and regulatory environment. Our Culture At Everest, our purpose is to provide the world with protection. We help clients and businesses thrive, fuel global economies, and create sustainable value for our colleagues, shareholders and the communities that we serve. We also pride ourselves on having a unique and inclusive culture which is driven by a unified set of values and behaviors. Our Values are the guiding principles that inform our decisions, actions and behaviors. They are an expression of our culture and an integral part of how we work: Talent. Thoughtful assumption of risk. Execution. Efficiency. Humility. Leadership. Collaboration. Diversity, Equity and Inclusion. Our Colleague Behaviors define how we operate and interact with each other no matter our location, level or function: Respect everyone. Pursue better. Lead by example. Own our outcomes. Win together. All colleagues are held accountable to upholding and supporting our values and behaviors across the company. This includes day to day interactions with fellow colleagues, and the global communities we serve. Type: Regular Time Type: Full time Primary Location: Santiago, Chile Additional Locations: GDPR Privacy Notice | Everest (everestglobal.com) Beware of recruitment fraud Please be cautious of phishing scams involving fake Everest job postings and individuals posting as Everest representatives making phony job offers. Always verify the identity of the recruiting professionals you work with. What you should know: At Everest, your privacy, security, and safety are of utmost importance to us. Everest will never ask for payment or any financial information as part of the hiring process. All job-related written communications from our internal recruitment team will come from official email addresses that end in our company domain. EVEREST is a leading international reinsurance and insurance group with an extensive distribution network that spans five continents. With roots dating back to 1973, Everest has developed a global footprint and deep client relationships that are largely unmatched by its peers. The Company’s principal business strategies seek to leverage its strengths to optimize returns over the underwriting cycle, thereby creating value for its shareholders and business partners.