Complex Case Commercial General Liability Claim Representative
Company: Travelers Group
Location: Diamond Bar
Posted on: November 22, 2021
Taking care of our customers, our communities and each other.
That's the Travelers Promise. By honoring this commitment, we have
maintained our reputation as one of the best property casualty
insurers in the industry for over 160 years. Join us to discover a
culture that is rooted in innovation and thrives on collaboration.
Imagine loving what you do and where you do it.
Job Description Summary
Under general supervision, this position is responsible for
investigating, evaluating, reserving, negotiating and resolving
assigned General Liability Bodily Injury and Property Damage
claims. Provides quality claim handling throughout the claim life
cycle (customer contacts, coverage, investigation, evaluation,
reserving, litigation management, negotiation and resolution)
including maintaining full compliance with internal and external
quality standards and state specific regulations. Provides
consulting and training resources, and serves as a contact and
technical resource to the field and our business partners. This job
does not manage staff.
Primary Job Duties & Responsibilities
- Directly handles assigned severity claims.
- Provides quality customer service and ensures file quality and
timely coverage analysis and communication with insured based on
application of policy information to facts or allegations of each
- Consults with Manager on use of Claim Coverage Counsel as
- Directly investigates each claim through prompt and
strategically-appropriate contact with appropriate parties such as
policyholders, accounts, claimants, law enforcement agencies,
witnesses, agents, medical providers and technical experts to
determine the extent of liability, damages, and contribution
potential. Interview witnesses and stakeholders; take necessary
statements, as strategically appropriate.
- Complete outside investigation as needed per case
- Actively engages in the identification, selection and direction
of appropriate internal and/or external resources for specific
activities required to effectively evaluate claims, such as
Subrogation, Risk Control, nurse consultants, and fire or fraud
investigators, and other experts.
- Verifies the nature and extent of injury or property damage by
obtaining and reviewing appropriate records and damage
- Maintains claim files and documents claim file activities in
accordance with established procedures.
- Utilizes evaluation documentation tools in accordance with
- Proactively reviews Claim File Analysis (CFA) for adherence to
quality standards and trend analysis.
- Utilizes diary management system to ensure that all claims are
- Establishes and maintains proper indemnity and expense
- Recommends appropriate cases for discussion at roundtable.
- Attends and/or present at roundtables/ authority discussions
for collaboration of technical expertise resulting in improved
payout on indemnity and expense.
- Actively and enthusiastically shares experience and knowledge
of creative resolution techniques to improve the claim results of
- Applies the Company's claim quality management protocols and
Best Practices to all claims; documents the rationale for any
departure from applicable protocols with or without
- Develops and employ creative resolution strategies.
- Responsible for prompt and proper disposition of all claims
within delegated authority.
- Negotiates disposition of claims with insureds and claimants or
their legal representatives.
- Recognizes and implements alternate means of resolution.
- Manages litigated claims. Develops litigation plan with staff
or panel counsel, including discovery and legal expenses, to assure
effective resolution and to satisfy customers.
- Applies litigation management through the selection of counsel,
evaluation and direction of claim and litigation strategy,
- Tracks and controls legal expenses to assure cost-effective
- Effectively and efficiently manages both allocated and
unallocated loss adjustment expenses.
- Attends depositions, mediations, arbitrations, pre-trials,
trials and all other legal proceedings, as needed.
- Updates appropriate parties as needed, providing new facts as
they become available, and their impact upon the liability analysis
and settlement options.
- Recognizes cases, based on severity/complexity protocols that
should be transferred to another level of claim professional and
refers on a timely basis.
- Appropriately deals with information that is considered
personal and confidential.
- Fulfills specific service commitments made to certain accounts,
as outlined in Special Account Communication (SAC) instructions and
inquiries from agents and brokers.
- Represents the company as a technical resource, attends legal
proceedings as needed, acts within established professional
guidelines as well as applicable state laws.
- Actively provides mentoring and coaching to less experienced
claim professionals to increase the technical expertise and improve
- Shares accountability with business partners to achieve and
sustain quality results.
- Evaluates all claims for recovery potential; directly handles
recovery efforts and/or engages and directs Company resources for
- In order to perform the essential functions of this job,
acquisition and maintenance of Insurance License(s) may be required
to comply with state and Travelers requirements. Generally,
license(s) must be obtained within three months of starting the job
and obtain ongoing continuing education credits as mandated.
- High School Degree or GED required with a minimum of 3 years
bodily injury litigation claim handling experience.
Education, Work Experience, & Knowledge
- Bachelor's Degree preferred.
- 4 years bodily injury litigation claim handling experience
- Advanced level knowledge in coverage, liability and damages
analysis and has a thorough understanding of the litigation
process, relevant case and statutory law and expert litigation
management skills preferred.
- Extensive claim and/or legal experience and technical expertise
to evaluate severe and complex claims preferred.
- Able to make independent decisions on most assigned cases
without involvement of supervisor preferred.
- Thorough understanding of business line products, policy
language, exclusions, ISO forms, and effective claims handling
Job Specific Technical Skills & Competencies
- Openness to the ideas and expertise of others actively solicits
input and shares ideas.
- Strong customer service skills. - Intermediate
- Demonstrated coaching, influence and persuasion skills.-
- Strong written and verbal communication skills are required so
as to understand, synthesize, interpret and convey, in a simplified
manner, complex data and information to audiences with varying
levels of expertise.- Intermediate
- Strong technology aptitude; ability to use business technology
tools to effectively research, track, and communicate information.
- Attention to detail ensuring accuracy -Intermediate
- Job Specific Technical Competencies:
- Analytical Thinking - Intermediate
- Judgment/Decision Making - Intermediate
- Communication - Intermediate
- Negotiation -Advanced
- Insurance Contract
- Knowledge - Advanced
- Principles of Investigation - Advanced
- Value Determination - Advanced
- Settlement Techniques - Intermediate
- Legal Knowledge - Intermediate
- Medical Knowledge - Intermediate
Environmental / Work Schedules / Other
Travelers is an equal opportunity employer. We value the unique
abilities and talents each individual brings to our organization
and recognize that we benefit in numerous ways from our
If you are a candidate and have specific questions regarding the
physical requirements of this role, please send us an email so we
may assist you.
Travelers reserves the right to fill this position at a level above
or below the level included in this posting.
Careers at Travelers
When you work at Travelers, life's most important moments become
your life's work. That means helping families feel secure,
businesses to prosper, knowing that you've made a difference, and
feeling like you belong to something bigger. It also means being
part of a team comprised of 30,000 + talented and passionate people
that are evolving to meet changing needs - from customer service to
data science and beyond. If that's more than you imagined in an
insurance career, it's time to join us at Travelers.
Keywords: Travelers Group, Diamond Bar , Complex Case Commercial General Liability Claim Representative, Other , Diamond Bar, California
Didn't find what you're looking for? Search again!