Field Adjuster, Property
York Risk Services Group is a premier provider of insurance, risk management, alternative risk, pool administration and claims management solutions to clients across hundreds of industries. Recently named by Forbes as one of "America's Best Midsized Companies Two Years in a Row" We firmly believe that our employees drive the success of the company. With success in mind as the ultimate goal, we strive to create and provide an environment that offers challenging, stimulating and financially rewarding opportunities.
The Field Adjuster is responsible for investigating, documenting and reporting on liability insurance claims of a moderate to high complexity by conducting a thorough gathering and analysis of appropriate evidence, determining feasibility and compensability of damages by reviewing the evidence and the applicability of coverage as well as the damages; may be involved in litigation.
ESSENTIAL JOB RESPONSIBILITIES:
- Investigate coverage, liability, compensability and damages to assist in determining the fact and/or conflicts in the evidence.
- Analyze situation to determine if appropriate evidence and been obtained, obtain and interpret official reports and claim forms;
- Formulate investigative approach to determine witness credibility by interviewing claimants and appropriate witnesses to gather a complete set of facts.
- Use your training, expertise, and judgment to determine probable courses of events and express an opinion as to liability and possible negligence.
- Be alert to insurance fraud and obtain supportive evidence at location. Inform and advise of any potential SIU issues for proper reporting.
- Review medical records to determine the extent of the injury is feasible per accident.
- Maintain expected caseloads and diary while meeting established service, production, quality, sales and educational objectives.
- Understand, apply and keep current your knowledge/license of the Federal laws, State laws, and Department of Insurance regulations as they apply to the claims.
- Evaluate and maintain acceptable product quality through application of and compliance service standards and internal quality control initiatives.
- Based on previous knowledge and expertise, investigate the possibility subrogation or other recovery from a third party and refer to the appropriate department.
- Technically guide and oversee experts, including but not limited to causes and origin experts, structural engineers, architects, and remediation experts, to further analyze causation and damages issues on behalf of the client.
- Utilize expertise and judgment to estimate initial reserves, reevaluate with circumstances as necessary, and provide insight regarding possible settlements.
- Use your training, experience, and judgment to negotiate with insureds, claimants, and vendors to reach an agreed settlement value as needed. Attend/participate at mediations, settlement conferences, hearings or trial.
- Be available for after-hours calls from clients for immediate analysis and independently response to accident scenes/loss locations to conduct investigation/claim management.
- May plan the work of staff members/vendors and may have some involvement with the coaching, developing, training and appraisal processes for subordinate team members
- BS / BA or Equivalent Work Experience
- Licenses as required
- Extensive experience applying principles of investigation management including immediate situational evaluation; application of investigative tools; determination of coverage and application to specific claim; case value analysis preliminary and ongoing; litigation principles; client management; negotiation and resolution of claims.
- Advanced knowledge of insurance coverage terms and application to factual situations
- Advanced understanding of claims handling principles as applied to field adjusting
- Knowledge of multi-jurisdictional claims handling issues including tort claims statues.
- Minimum of 5-7 years of industry experience in investigating and evaluating casualty claims with demonstrated successful track record of independently gathering and analyzing of the facts for the claims, including analysis of policy coverage issues.
- Advanced ability to apply applicable fair claims handling requirements of the correct jurisdiction and apply these concepts on behalf Yorks to fulfill its duty to the client.
- Read, comprehend and apply general liability policies language to complex situations
- Capable of identifying and thoroughly investigating liability issues per claim type.
- Advanced oral and written communication and presentation skills; Analytical and interpretive skills; ability to prepare a well-reasoned report, including a coverage/negligence/causation/damages estimate, as appropriate
- Highly organized with top time management skills including setting priorities; self-starter
- Excellent interpersonal skills and customer service skills
- Practiced level headed approach in potentially disastrous situations
- Repeatedly demonstrates high levels of discretion and independent judgment
- PC literate, including Microsoft Office products, from diverse locations.