Title

Litigation Claims Specialist 


About the Organization National General Insurance (formerly GMAC 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.

NGIC is a fast paced, dynamic, and entrepreneurial organization. Our employees live by and exemplify what we call the 4Es. We at NGIC are Energized, Engaged, Empowered, and we come into work every day determined to Execute on what is needed and expected of us. We are passionate about our organization and the value that we add every day. A successful with NGIC candidate will embody the 4Es.  

Location Ohio- Cleveland  

Description

Basic Function – Handles initial losses where injuries are reported.

Independently investigates the facts of loss, determines and verifies coverage and liability, evaluates settlement value and settlement options and negotiates injury claims within authority granted.  Bodily injury claims handled are generally lower level injury claims.

Injury claims with substantial damage and/or exposure exceeding authority granted may be handled, with oversight, and incumbent will recommend plan of action to resolve any coverage, liability, and damage or settlement issues to next level of file supervision.

Claims handled will require independent analysis and research to resolve coverage, liability, damage and settlement issues.

Responsible for maintaining and growing a relationship between GMAC Insurance and current policyholders.  Also responsible for focusing on the needs of loss participants.  Identifies customer needs and works to meet those needs using appropriate Point Of Difference skills.

 

Duties and Responsibilities – For all duties and responsibilities, incumbent will take ownership of any issue, problem, or error that could potentially impact the policyholder and/or loss participant.

1. Develop a basic understanding and knowledge of state laws and regulations applicable to claims handled, including state unfair claim practice laws, and exhibit the basic ability to independently interpret these laws and regulations as it relates to handling of bodily injury claims assigned. 

2. Receives initial claim assignments, investigates and confirms coverage and documents basis for granting of coverage. Supervisor may be involved with review of claims to ensure that they are commensurate with ability.  10%

3. Establishes liability investigation plan with the MD TCR; may assist in the investigation by gathering facts and evidence with all witnesses and interested parties; takes recorded statements when necessary; may analyze extent of property damage. Reviews loss reserves and adjusts or opens hidden exposures as necessary. 10%

4.Determines if potential subrogation or fraud issues exist and refers to appropriate claim Unit for handling, with recommendation on plan of action, or may independently determine to handle issues to conclusion.

5. Gather, analyze and evaluate, for settlement purposes, all supportive medical documentation (may include obtaining medical authorizations, medical and lost wage records as necessary).  20%

6. Must understand GMACI Claim Handling Guidelines and exhibit the ability to independently interpret and apply these guidelines to all claims handled.

7. Independently resolves coverage, liability and damage issues, establishes settlement value and negotiates claim to conclusion on all claims within authority granted. For claims with value exceeding authority granted, incumbent will recommend a plan of action for resolution of the claim to manager for approval.  25%

8. Determines and documents basis of settlement value, settlement options, release documents needed, parties needed to conclude settlement and plan of action to negotiate settlement. Makes contact with appropriate party (is) to negotiate a settlement and obtains all necessary settlement documents to conclude settlement and claim. 25%

9. Performs other projects and assignments as agreed upon with designated claims management.  5%

10.  May handle more complex files and / or litigation with appropriate supervision. Incumbent will recommend a plan of action for resolution of the claim to appropriate supervisor for approval.  5%

 

 

Position Requirements

Technical Competencies - Successful completion of adjuster trainee program for internal employees and external candidates.

Incumbent must demonstrate proficiency in skills learned in training.

Demonstrates the capability of consistently handling claims within authority granted with limited to no supervision.

For claims with value exceeding authority granted, incumbent demonstrate ability to recommend a plan of action for resolution of the claim to manager for approval.

Obtains/Maintains appropriate licensing or education requirements.

Has a basic understanding and knowledge of state laws, regulations and GMACI Claims Handling Guidelines applicable to claims handled, including state unfair claim practice laws, and exhibits the basic ability to independently interpret these laws and regulations as it relates to handling of bodily injury claims assigned. 

Demonstrates the ability to independently interpret and apply coverage accurately.  Often requires assistance on more complex files but is expected to recommend plan of action, to resolve coverage issue, to appropriate file supervisor.

Basic understanding and interpretation of   vehicle repair estimates.

 Exhibits the basic ability and knowledge to review, evaluate, and negotiate injury claims.  Utilizes ADR and other tools when appropriate.

If handling litigation, demonstrates basic knowledge of the litigation process, knowledge of applicable GMACI litigation policies and procedures and exhibits ability to interpret and apply this knowledge to claim in litigation.  This person will also recognize legal issues and will utilize ADR when appropriate.

Successful completion of initial casualty training.

 

Additional Competencies – Demonstrates a thorough and consistent pattern of understanding and demonstrating our GMAC Insurance Point of Difference.

Requires a high degree of initiative, independent judgment, and discretion.  Ability to resolve conflicts and empathize with customers is critical.  Negotiation skills are important for resolving claims.

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

Demonstrates a general understanding of insurance law and able to interpret and apply these laws as it relates to claims.  Begins to understand handling claims in litigation.

Demonstrates a general understanding of the insurance industry and organizational relationships of the company.  Also, demonstrates an understanding of the functions of other departments, such as Policy Ops and Marketing

 

Tags  


This position is currently accepting applications.



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