"Alerted.org

Complex Claims Adjuster

122807

Zurich Cover More is seeking a Complex Claims Adjusterto join our Group in North America.

The role of a Complex Adjuster is to handle claims of varying degrees of complexity with all travel insurance benefits. Claim processing benefits including but not limite to: Mid to high exposure Trip Cancelations, Travel Post Departure events (trip interruption, trip delay, baggage), travel medical, evacuation/repatriation and AD&D as well as providing claims determination on emergency assistance cases in real time. As a Complex Claims Adjuster you are responsible for an accurate and thorough review of claim documents, investigations, file notes documenting your action plans based upon the applicable law, coverage and supporting evidence. This position will also provides on-going communication to the appropriate stake holders through the life of the claim. This role involves claims in which real time decisions are required and frequent conversations with insureds in critical situations.

What Complex Claims Adjuster is responsible for:

Maintains high standards of customer service. This includes prompt contact and follow-up to complete timely and accurate investigation, damage evaluation and claim resolution in accordance with regulatory and company standards.

Conducts a thorough investigation of coverage, liability, and damages while appropriately documenting facts and maintaining evidence to support claim resolution.

Comply with all statutory and regulatory requirements in all applicable jurisdictions.

Establish appropriate loss and expense reserves with documented rationale. On-going review of reserves required through life of file.

Demonstrate technical efficiency through timely, consistent execution of best claim handling practices and claim handling guidelines.

Communicates effectively both verbally and in writing with internal and external customers.

Maintain and manage diary system to effectively manage pending claims inventory.

Proficiency in Desk Management, time management and dealing with escalated insureds.

Meet quality standards by following best practices

Basic Qualifications:

High school diploma or equivalent and 2+ years claims handling

Preferred Qualifications:

Claims experience in bodily injury preferred but not required

State specific adjuster licensing is required and must be obtained within two (2) months of the business initiating the licensing process.

Excellent verbal and written communication skills with an ability to handle escalated insureds.

Proficiency in Microsoft Office.

EOE Disability / Veterans