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Allstate Insurance Company has an exceptional career opportunity for an Experienced Represented Casualty Adjuster in Houston, TX!
About the Team
The Adjusting Function is responsible for verifying policy coverage and limits. The Adjusting function investigates and evaluates damage and/or liability; estimates damages, losses, or total indemnity; sets and maintains reserves; and/or negotiates and settles claims. Third party liability and casualty claims involve coverage and liability investigation, negotiation, and settlement of policyholder and third-party liability, property damage, and bodily injury claims.
About the Position
Under limited supervision, this job is responsible for investigating complex claims when an attorney is representing the injured party which typically will include: (1) uninsured or underinsured motorist (UM/UIM) claims in single or multi car accidents; (2) Injury Casualty Soft Tissue (ICST), and represented- moderate or major claims; (3) complex Commercial Property Liability (CPL) or extra-contractual liability claims; (4) or specialized claims (e.g., business interruption, loss of income, E&O policies, etc.). The individual also handles claims involved in litigation, arbitration or mediation, coordinating with legal counsel and participating in depositions, hearings, trial, or arbitrations. The individual takes recorded statements, resolves loss of use claims, makes payments to appropriate parties, and negotiates and settles or refers bodily injury issues that cannot be resolved.
Specific responsibilities include:
• Researches and responds to moderately complex customer communications, concerns, conflicts or issues
• Reviews customer satisfaction results; works independently to create personal action plans
File Documentation and Reporting
• Documents a claim file with notes, evaluations and decision making process
Coverage, Liability and Evaluation
• Determines and explains minimum coverage limits in complex claims involving single or multiple claimants
• Sets initial reserve, updates reserve, documents rationale and claim summary notes
• Obtains photos and/or conducts scene investigation
• Takes recorded statements from claimants, insureds, witnesses, medical providers, etc., conducts investigations into complex auto accidents, determines liability and prepares summaries
• Evaluates and determines potential use of experts; reviews reports and participates in selecting the expert
• Determines claim value
• Reviews file to identify complex potential legal issues
Negotiation and Settlement Guidance
• Negotiates and settles claims in accordance with business unit best practices
• Reviews medical reports in preparation for claims settlement evaluation
Other Projects and Responsibilities
• May serve as a committee team lead for medium-sized projects or as a committee team member on large projects
• May serve as a subrogation or arbitration panelist
• May serve as an agent advocate
• Participates in targeted reviews
• Researches, responds to, or participates in Department of Insurance complaints or investigations
• Assists in reviewing files and making recommendations to refer files to Home Office for escalation
• Assists in researching or responding to or resolving complex compliance issues
• Bachelors degree in related field preferred or equivalent experience
• 5 - 10 years of experience investigating evaluating, negotiating and setting moderately complex claims strongly preferred
• Excellent written and verbal communication skills with a passion for helping others.
• Strong organizational and computer skills.
• Persistence and the ability to work through and solve problems.
• Has and maintains all appropriate licenses and registrations for the role per state requirements
• Ability to investigate, evaluate, negotiate and settle complex claims
• Provides broad individual decision making within authority limits
The candidate(s) offered this position will be required to submit to a background investigation, which includes a drug screen.
Good Work. Good Life. Good Hands®.
As a Fortune 100 company and industry leader, we provide a competitive salary – but that’s just the beginning. Our Total Rewards package also offers benefits like tuition assistance, medical and dental insurance, as well as a robust pension and 401(k). Plus, you’ll have access to a wide variety of programs to help you balance your work and personal life -- including a generous paid time off policy.