Location: Simi Valley
Posted on: January 10, 2022
Chubb is the world's largest publicly traded property and
casualty insurer. With operations in 54 countries, Chubb provides
commercial and personal property and casualty insurance, personal
accident and supplemental health insurance, reinsurance and life
insurance to a diverse group of clients. The company is
distinguished by its extensive product and service offerings, broad
distribution capabilities, exceptional financial strength,
underwriting excellence, superior claims handling expertise and
local operations globally.
ESIS, Inc. (ESIS) -provides sophisticated risk management services
designed to reduce claims frequency and loss costs. ESIS, the Risk
Management Services Company of Chubb, provides claims, risk control
& loss information systems to Fortune 1000 accounts. ESIS employs
more than 1,500 professionals in nine regional centers and 15 major
claims offices, as well as local representatives in select
jurisdictions. We take our fiduciary responsibilities seriously and
are proud to manage over $2.5 billion of customer losses and over
320,000 new claims annually. We specialize in large accounts which
have multi-state operations. For information regarding ESIS please
visit - www.esis.com .
The ESIS Senior Work comp Claim Representative, under the direction
of the Claims Team Leader, investigates and settles claims
promptly, equitably and within established best practices
Under the direction of the Claims Team Leader investigates and
settles claims promptly, equitably and within established best
MAJOR DUTIES & RESPONSIBILITIES:
Duties may include but are not limited to:
Reviews claim and policy information to provide background for
investigation and may determine the extent of the policy's
obligation to the insured depending on the line of business.
Contacts, interviews and obtains statements (recorded or in person)
from insureds, claimants, witnesses, physicians, attorneys, police
officers, etc. to secure necessary claim information.
Depending on line of business may inspect and appraise damage for
property losses or arranges for such appraisal.
Evaluates facts supplied by investigation to determine extent of
liability of the insured, if any, and extend of the company's
obligation to the insured under the policy contract.
Prepares reports on investigation, settlements, denials of claims,
individual evaluation of involved parties etc.
Sets reserves within authority limits and recommends reserve
changes to Team Leader.
Reviews progress and status of claims with Team Leader and
discusses problems and suggested remedial actions.
Prepares and submits to Team Leader unusual or possible undesirable
Assists Team Leader in developing methods and improvements for
Settles claims promptly and equitably.
Obtains releases, proofs of loss or compensation agreements and
issues company drafts in payments for claims.
Informs claimants, insureds/customers or attorney of denial of
claim when applicable.
May assist Team Leader and company attorneys in preparing cases for
trial by arranging for attendance of witnesses and taking
statements. - Continues efforts to settle claims before trial.
Refers claims to subrogation as appropriate. - May arrange for
salvage disposition or other recovery proceedings as necessary by
line of business.
May participate in claim file reviews and audits with
customer/insured and broker.
Administers benefits timely and appropriately. - Maintains control
of claim's resolution process to minimize current exposure and
Establishes and maintains strong customer relations
Depending on line of business, other duties may include:
Maintaining system logs
Investigating compensability and benefit entitlement
Reviewing and approving medical bill payments
Managing vocational rehabilitation
SCOPE INFORMATION: (include operating budget, revenue goals,
reporting relationships, # of direct/indirect reports, etc.) - -
The position reports directly to a Claims Team Leader or other
member of claims management.
2-5 years experience handling claims in a relevant line of
Basic knowledge of claims handling and familiarity with claims
Effective negotiation skills
Strong communication and interpersonal skills to be capable of
dealing with claimants, customers, insureds, brokers, attorneys etc
in a positive manner concerning losses.
Ability to self motivate and work independently
Knowledge of Chubb products, services, coverages and policy limits,
along with awareness of Chubb claims best practices
Keywords: Chubb, Simi Valley , Claim Representative, Other , Simi Valley, California
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