Apply on Employer Site

Legal & General America · 23 hours ago

Claims Representative I

US-MD-Frederick

Full-time

Hybrid

Entry Level

$48K/yr - $55K/yr

1+ years exp

Legal & General America is a recognized market leader of term life insurance, focused on transforming their business through innovation and technology. The Claims Representative is responsible for the setup, research, review, and processing of non-contestable claims and live rescissions, ensuring compliance with productivity and quality standards.

ConsultingFinancial ServicesInsuranceLegalLife Insurance

Comp. & Benefits

Responsibilities

Review and process live rescissions within established productivity and quality standards

Prepare written communication to insureds regarding rescission of in force life insurance policies

Set up, research, review and process non-contestable claims within established productivity and quality standards

Review company records to confirm insurance coverage

Review all beneficiary and title changes and collateral assignments for correctness and generate appropriate correspondence in accordance with state insurance regulations requesting appropriate claim requirements

Open claims files according to departmental procedure

Notify reinsurers of newly filed death claims

Evaluate documentation submitted for processing of claim and confirm eligibility for payment utilizing knowledge of estates, trusts, minor beneficiary requirements, divorce statutes and other regulatory requirements. If documentation is insufficient, request correct or additional requirements needed in order to give the claim further consideration

Correspond and communicate with claimants, attorneys, agents, reinsurers and other company departmental staff to discuss and/or resolve matters relevant to effective claims administration, including competing claim issues

Review progress and status of pending claims with management and discuss problems and suggested solutions

Follow up on all pending non-contestable claims within established regulatory requirements

Follow established escheat procedures on pending claims review and run public records database searches as needed

Process claim on administrative systems using the appropriate Post Mortem Interest statutes, dividend calculations, and contract provisions to reflect settlement or payment of claim to the appropriate party

Send disbursement correspondence and document file reflecting interest and payment amount

Document all activity to support claim file

Answer phones and respond to correspondence pertaining to the initial notification of death

Keep abreast of 'red flags' for fraud and identify potential issues to prevent payment of fraudulent claims including foreign death requirements

Complete form 712’s as needed

As required, bill reinsurer for their share of the liability and update appropriate system. Communicate with reinsurers as needed on problem cases

Keep abreast of claims related regulatory requirements

Operate in a team environment and support other team members to enhance overall productivity

Complete all other projects and tasks assigned by management

Qualification

Spreadsheet softwareWord processing softwareMicrosoft OfficeTyping 35 WPMCustomer service skillsProduct knowledgeAnalytical skillsDetail orientedOrganization skillsVerbal communicationWritten communicationProblem solving skillsNegotiation skillsFast-paced environment