Island Insurance · 12 hours ago
Senior Claims Specialist - Casualty
Honolulu, HI
Full-time
Onsite
Mid, Senior Level
$90K/yr - $105K/yr
5+ years expIsland Insurance is a company that specializes in providing insurance services, and they are seeking a Senior Claims Specialist to handle complex claims from first notice to final disposition. The role involves coverage analysis, investigation, litigation management, and negotiation of various claims, ensuring thorough documentation and adherence to legal statutes.
Insurance
Responsibilities
Receive claim loss information from agencies, insured, and claimants or other involved parties via telephone, facsimile, mail, or computer; and establish a claim on the appropriate computer claim handling system
Review limited assignments as well as assigned claims for applicable coverage, liability, and exposures
Handle those losses or litigated claims involving the greatest complexity
Must have thorough knowledge of all lines of business written by the company, including, but not limited to auto, homeowners, dwelling fire, commercial general liability, and umbrella
Review applicable policy forms, determine and explain available coverage/benefits, resolve conflicts
Contact insured and other involved parties within the specified time frame, as outlined by department procedure
Determine/confirm facts of loss/cause of loss, identify parties involved, and extent of injuries or damages, as applicable
Obtain written or recorded statement(s) as needed
Inspect, photograph, and diagram damages and the scene of loss. Ensure the investigation is thorough and complete, and documentation in the file supports the claim. Secure and preserve evidence
Obtain other documentation, as appropriate, including but not limited to police and fire investigative reports, applicable contracts, plans and specifications, diagrams and photographs, repair proposals and appraisals, and medical records and bills
Determine liability based on facts developed and thorough knowledge of the applicable Hawaii Revised Statutes and other applicable laws
Provide clear and concise analysis of liability based on the facts and the applicable Hawaii Revised Statutes and other applicable laws
Provide analysis of alleged damages and injuries
Initiate deductible recovery procedures where applicable
Review questionable claims and all coverage issues with the Claim Manager
Communicate status to insureds, claimants, and their attorneys, if any, as required by the Hawaii Revised Statutes or per department policy
Stay abreast of statute, case law decisions, as well as policy and coverage changes
Possess a positive, service-oriented attitude toward agencies, insureds, and employees within the company
Provide quality claims handling and superior customer service on a regular basis
Serve as a mentor to other claims professionals in a technical capacity
Assist other claim professionals with claims handling, evaluations, negotiations, and litigation issues
Provide technical advice/direction to department personnel on more complex claims
Assist with the assignment of claim assignments as needed, reviewing first notices of loss, providing direction, and support to the assigned individual
Perform appropriate and timely processing of financial transactions, including establishing reserves, adjusting reserves, and making payments on the applicable claim system, as authorized
Prepare and submit written requests for authority, as well as other reports, as required
Evaluate damages and injuries considering applicable coverage, liability determination, and other pertinent information developed
Negotiate settlements within authority granted
Enter timely, clear, and concise notes on the applicable computer claim handling system to document all activities – investigations, evaluations, recommendations, negotiations, and resolution
Diary all assigned claim files for timely follow-up and review them within the specified time frame as outlined by department procedure
Manage all outside vendors (e.g., independent adjusters, appraisers, contractors, investigators, experts, and attorneys) to minimize the length of time to resolution of the claim, and the allocated loss expenses
Follow prescribed litigation guidelines and procedures including reporting requirements and attorney fee review program
Attend and participate in mediations, arbitrations, settlement conferences as required
Perform accurate and timely preparation and submission of data and reports, as required by the department procedure or management
Qualification
Required
High school diploma or general education degree (GED); and 5-7 years multi-line Claims Specialist required
Continuing education in insurance and job-related issues and subjects required
Valid Hawaii Driver's license and use of own vehicle required
Preferred
College degree with credits in insurance related subjects preferred
State of Hawaii general adjusting license preferred
Enrollment or completion of IIA, AIC or other insurance industry courses preferred
Company
Island Insurance
Protecting Hawaii's families and businesses for over 80 years, Island Insurance is the first and only Hawaii-based company to be recognized as one of the Top 50 property & casualty (P&C) insurance companies in the nation by the Ward Group for 14 consecutive years.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Scott Kuioka
Chief Operating Officer
Nova P Kim, CPCU
Island Insurance Agency/Agency Partners Program Manager
Recent News
Business Journals
2022-07-14
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2022-02-25
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