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Title

NY PIP Litigation Specialist 

EOE StatementWe are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.
 
Location New York - Albany  
Territory/Region  
Category Claims  
Description

Review and handle litigation claims for the PIP Center.

Ensure compliance with GMACI Claims Handling Guidelines.

Ensure compliance with regional laws, rules, and procedures.

Ensure reinsurance reporting is completed in accordance with our treaty obligations.

Guard against extra-contractual claims against insured and company.

Serves as litigation and technical specialist for PIP Center.

Discuss any changes in Claims handling and litigation related procedures during regional conference calls (monthly – quarterly).

When consulting on claims involved in litigation, the PIP Litigation Specialist will:

  • Work with claim handlers and outside counsel toward achieving the most expeditious and cost-efficient resolution possible. Conduct negotiations and settlements within authority level to aid in the resolution.
  • Track and document the quality of service provided by defense counsel and manage litigation and recovery costs.
  • Assist claim handlers and/or their respective managers with research of complex issues and development of defense strategies on litigated files.
  • Attend trials and meditations as appropriate with managerial approval.
  • Direct handle claim files involving complex litigation

Analyzes, evaluates and adjusts claims within limit of authority in compliance with statutory regulations and fair claim practices; makes decisions on best options. Summarizes claims in excess of authority and submits to manager for approval.

Evaluates settlement alternatives by reviewing regulatory compliance and fair claims practices; makes decisions on best option. Makes appropriate contacts to discuss a settlement; extends an offer to appropriate party; documents all file activity and settlement information in file notes clearly outlining basis for settlement.

Review and analysis of medical claims, including, but not limited to, the analysis and interpretation of medical records and reports and utilization of Independent Medical Examinations, peer reviews, case management, coding reviews, and Diagnostic Related Group (DRG) audits.

Recognizes how to determine if subrogation exists when additional payments are made and how to handle. May refer claim to appropriate business unit for further handling.

Performs other projects and assignments as directed, including, but not limited to, assisting in training PIP trainees and other PIP Reps, with possible attendance at depositions, arbitrations and hearings

 
Position Requirements

 

3 or more years experience handling New York no-fault claims. Knowledge of Regulation 68, Personal Injury Protection law, medical terminology, and policy coverage's.

Requires a high degree of initiative, mature judgment, and discretion.

Ability to resolve conflicts and empathize with customers is critical. Negotiation skills are critical for resolving claims.

Demonstrates professional oral and written communication skills. Organization and time management skills are critical for this position.

Experience handling NY No Fault Litigation and Arbitration Claims

Demonstrates a solid understanding of insurance law as it relates to claims.

Ability to travel to attend Trials, Arbitration's, depositions and any trail related hearings as needed

Qualifications desired: prefer successful completion of one or more of the following: CPCU, AIC (Associate in Claims), SCLA (Senior Claims Law Associate (to include FCLS (Fraud), PCLS (Property), CCLS (Casualty), and LPCS (Legal Principles), advanced educational degree such as MBA/JD

 
About the Organization National General Insurance is one of the largest automobile insurers in the United States. National General Insurance offers a variety of property and casualty products, including personal auto, RV, motorcycle, commercial auto and homeowners insurance. With a nationwide network of claims professionals, local independent agents and a 24-hour, toll-free claims hotline available 365 days a year, National General Insurance provides superior claims service for its customers.

National General is a fast paced, dynamic, and entrepreneurial organization. Our team members live by and exemplify what we call the 4Es. At National General, we are Energized, Engaged, Empowered, and we Execute every day in order to provide an exceptional experience for our customers! We are passionate about our organization and the value that we add every day. A successful candidate with National General will embody the 4Es. Our team is poised to outperform the competition. We are National General Insurance and with us you can be extraordinary! Come join our team!

In addition to a phenomenal career opportunity, National General Insurance offers an excellent benefits package including:

• Paid Training
• Medical, Dental, Vision benefits
• Wellness Programs
• Life and Short/Long Term Disability Insurance
• 401k w/ company match
• Company Paid Holidays
• Generous Time-off policy
• On-site Healthcare Clinic (Winston-Salem and Cleveland offices)
• Subsidized parking (Downtown Cleveland)
 
Req Number CLA-13-00031  

This position is currently not accepting applications.

To search for an open position, please go to http://NationalGeneral.appone.com



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