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Claims Adjuster Trainee

Company: National General Insurance
Location: Winston Salem
Posted on: November 22, 2021

Job Description:

Primary Purpose: Examine claims data, investigate the facts of loss, determine coverage and liability, and adjusts claims within limit of authority. Claims involved are usually subject to standardized procedures which lead to a settlement with limited exercise of discretion. Claims involved occasionally require analysis and may require research to resolve coverage and/or damage issues. There is supervisory review of ongoing progress and results of work. There is more focused supervision on all complex files. Primary Purpose: Examine claims data, investigate the facts of loss, determine coverage and liability, and adjusts claims within limit of authority. Essential Duties and Responsibilities: Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.

  • Establish an investigative plan; initiate investigation by gathering facts and evidence with all interested parties; complete appropriate reports; take recorded statements when necessary, may review loss reserves and adjust or opens hidden exposures as necessary
  • Evaluate and adjust claims within limit of authority and summarize claims in excess of authority and submit to manager for approval
  • Evaluate settlement alternatives by reviewing regulatory compliance and fair claims practices; make decisions on best option
  • Make appropriate contacts to discuss a settlement; extend an offer to appropriate party; document all file activity and payment/settlement information in file notes clearly outlining basis for settlement
  • Determine subrogation or fraud potential and refer to Unit when potential exists or handle to conclusion
  • Identify customer needs and work to meet those needs using appropriate customer service skills
  • Develop an understanding of the functions of other departments, such as Policy Ops and MarketingTrainee
    • Shadow and learn the above stated essential duties and responsibilities
    • Learn to handle most aspects of auto claims
    • Develop a basic understanding of the content of policies written by the company
    • Develop a basic understanding of the insurance industry and the organizational relationships of the company
    • Learn how to determine subrogation or fraud potential and how to handle
    • Develop a basic understanding of systems and technology used within the companyLevel I
      • Receive claim assignments and verify/investigate coverage and document all appropriate information before Manager is involved with review of claims to ensure they are commensurate with ability
      • May handle more complex files with appropriate supervision to develop skills
      • Develop a working knowledge of systems and technology used within the companyf #LI-MG1

Keywords: National General Insurance, Winston-Salem , Claims Adjuster Trainee, Other , Winston Salem, North Carolina

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