What are the responsibilities and job description for the Inside Property Claim Representative position at Westfield?
Westfield Property Claims resolves first party personal, commercial, and agriculture property claims, which includes but is not limited to structural damage, business and personal property, and business income. The Claims Representative works independently under moderate supervision to determine coverage, investigate claim details, establishes damages, negotiates, and settle claims. The role prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties, facilitates and supports the execution of action plans and delivers quality customer services in a moderate complex work environment.
- Determines whether proper coverage exists for the type of claim assigned.
- Investigates thoroughly to obtain relevant facts concerning all aspects of the claim, such as coverage, potential exposure, damages, legal climate, and makes decisions on claim resolution.
- Determines the value of physical damage of property, through appropriate tools and vendors, recognizes claim file exposures and escalates claims appropriately based on claim severity and complexity.
- Negotiates claim resolution as needed with insureds, attorneys, and other insurance companies. Manages approved vendors and counsel utilized as necessary in the claim process, including approval of investigation plans and budgets.
- Monitors, reviews, and issues payments to vendors and counsel in accordance with guidelines and standards.
- Establishes proper reserves for each claim based upon thorough investigation, evaluation, and experience. Ensures timely & accurate reserve practices are being followed to cultivate favorable reserve adequacy results.
- Sets reserves within authority limits and recommends reserve changes to team leader, processes financial transactions such as stop pays, reissues, payment transfers, etc. within guidelines.
- Refers claims exceeding authority to appropriate manager or complex claims specialist with recommendations.
- Meets established goals & objectives, arranges for salvage disposition and other recovery proceedings as necessary, participates in claim file reviews and audits with customer and broker.
- Formulates sound recommendations for claims file handling.
- Requests additional information from an agent or other parties to assist in the claim investigation
- Maintains effective and ongoing communication with insureds, agents, attorneys, other insurance companies, representatives, vendors, and company personnel.
- Completes appropriate reports to ensure that the claim status is clearly documented, obtains all necessary documentation to support claim evaluation.
- Interprets complex and detailed documents such as contracts, legal documents, insurance regulations and policies as needed.
- Maintains knowledge of related coverage, law, and legislative environment and trends, participates in professional industry groups staying abreast of industry changes and advancements and incorporates best practices.
- Establishes and maintains positive relationships with internal and external customers resolving conflict around disputed benefits and providing excellent customer service.
Qualifications
Behavioral Competencies :
