Claims Analyst/Inspector (Property \u0026 Casualty)
- San Diego, CA
PURPOSE OF THE JOB
The purpose of this job is to ensure timely management and resolution of complex exposure property, liability, and related claims in compliance with applicable regulations and best practices. The position performs building inspections for DIC (Earthquake and flood) underwriting between catastrophe claim events. This position exists to ensure that claims are processed efficiently and effectively.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Takes responsibility for all aspects of claims assigned.
- Determines coverage on assigned cases and issues timely coverage letters as appropriate, subject to management approval.
- Conducts timely and thorough claims investigations.
- Handles claims proactively with the goal of resolving them at the earliest opportunity, while following the applicable claims regulations and fair claims practices.
- Utilizes a claims diary system to follow up on claims.
- Attends settlement conferences and other meetings necessary to developing or resolving a claim.
- Manages any and all special account/special risk considerations relating to any claim file or account.
- Manages all activities of independent adjusters/third party claims administrators assigned to handle catastrophe or non-catastrophe claims.
- Oversees investigation, coverage analysis, reserves and payments, settlements, and all other essential functions of claims handling.
Utilizes and directs resources pertinent to resolving claims.
- Manages and directs independent adjusters.
- Identifies when to retain, manage, and direct other vendors necessary to resolve claims; including contents specialists, accountants, contractors, appraisers, salvage specialists, restoration specialists, cause and origin specialists, and coverage counsel.
- Interfaces with and resolves claims with public adjusters and attorneys hired by policyholders.
- Stays conversant with case law and statutes applicable to property claims.
- Stays abreast of pertinent case law and insurance coverage developments.
Conducts building inspections as assigned by DIC Underwriting
- Schedules and coordinates building inspection schedule based on assignments from underwriters throughout assigned territory.
- Conducts building inspections and completes inspection report utilizing assigned software.
- Submits reports timely based on statutory deadlines.
- Provides additional advice to underwriters as necessary based on inspections, including any preexisting damages noted.
This role does not have supervisory responsibilities.
EDUCATION AND EXPERIENCE
Bachelor's degree from four-year college or university preferred with major or emphasis in Business Administration, Management, Economics, Sociology, or related field.
Minimum 1 – 2 years of property claims experience and/or training; or equivalent combination of education and experience required.
CERTIFICATES, LICENSES, REGISTRATIONS
Earthquake claims certification (California) required and can be obtained after hire. Adjuster’s licenses in various states may be required and can be obtained after hire.
California Driver’s License required.
KNOWLEDGE AND SKILLS
Ability to read, analyze, and interpret the most complex documents. Ability to respond effectively to the most sensitive inquiries or complaints. Ability to write speeches and articles using original or innovative techniques or style. Ability to make effective and persuasive speeches and presentations on controversial or complex topics to top management, public groups, and/or boards of directors. Ability to apply concepts of basic algebra and geometry. Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems. Ability to follow proper building inspection techniques.
Office environment – no specific or unusual physical or environmental demands and employees are regularly required to sit, walk, stand, talk, and hear. Extended standing and/or walking and climbing ladders may be required at building inspection sites. Travel required to building inspection sites up to 75% of the time in the field in the California region. Must be able to drive and be comfortable working independently.
This position maps to the Individual Contributor level. Additional competencies required: Initiative, Problem Solving & Decision Making, and Informal Communication.
This position operates in an office environment and requires the frequent use of a computer, telephone, copier, and other standard office equipment. Building inspection site requirements may result in exposure to dust and debris and may vary in the environment at each site. The noise level in the work environment at building inspection sites may be moderate to loud.
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