Permanent General Companies, Inc., also known as "The General" Insurance Company is a leading non-standard auto insurance provider. Currently we are seeking qualified applicants for Complex Claims Adjuster. We offer great training, a well-defined career path and a fun and challenging work environment where the right candidate will learn and grow with the company. We pride ourselves on teamwork and quality customer service. If you do too, please check us out!
Permanent General offers a generous benefits package to its employees including medical, dental, vision and life insurance after one month of employment; health care and dependent care flexible spending accounts, tuition reimbursement, paid time off (vacation, sick, holidays), 401(k) participation with a matching contribution, wellness initiatives and much more!
A Complex Claims Adjuster is responsible for a caseload consisting of claims involving the most technically challenging claims encountered by the company, including serious and catastrophic injuries and/or complex coverage issues. The highest level of technical competence is required. This position will require in depth technical knowledge of every state in which the company does business. Such knowledge includes liability, damages, evidence, coverage and other complex legal issues. This position requires thorough and complete investigations to gather sufficient information to make informed and knowledgeable coverage and liability decisions. Must also be able to develop exposures and evaluate injury claims fairly and equitably based on the damages as well as the insurance contract and in accordance to company policies and applicable state laws. Will serve as a technical resource to the entire claims department with regard to serious injuries and complex coverage and other legal issues.
Investigate and evaluate coverage, liability and damages in handling of claims involving serious and catastrophic injuries, complex coverage and other legal issues.
Provide technical support to the claims branches on serious and complex liability, damages and coverage issues.
Manage defense counsel in litigation of serious and complex claims to ensure that the company and its insured’s interest are protected.
Evaluate and negotiate fair and equitable settlements and obtain proper closing documents.
Maintain proper reserves on all pending claims.
Maintain current diary on all claims and review and address mail as outlined in departmental goals.
Maintain a 1:1 closing ratio.
Provide excellent customer service not only to our outside customers but also to other departments within the company.
Meet and maintain general file handling goals and procedures as outlined by the company.
Properly utilize the claim system and understand its features and functionality.
Submit all evaluation and payment authorities over $10,000 to Complex Claim Manager for review and approval.
Ensure timely referral of suits to counsel and continue to evaluate the changes in exposure through the course of discovery, considering costs and strategic plan of actions to prepare for trial or determine settlement capability.
Attend any available seminars and classes applicable to this position and the skills required to meet the job duties and responsibilities.
Assist with special projects within the department.
Other duties as assigned.
7 years claims handling experience with a minimum of 4 years casualty experience.
Has expert knowledge of claims policies and procedures and / or providing technical direction to claims personnel for claims handling.
Has expert knowledge in all states in which the company does business especially regarding complex litigation, serious and catastrophic injuries.
Demonstrates the ability to interpret and apply written coverage accurately to establish claim and determine action plan.
Demonstrates expertise in the knowledge of applicable statutes, regulations, case law and procedures relating to personal lines litigation, including negligence, insurance contract, insurance coverage, no-fault (PIP), theories of liability, state and federal civil procedure and alternative dispute resolution.
Demonstrates advanced expertise in the knowledge of insurance policies, provisions, coverage’s, rights and exclusions.
Demonstrates advanced knowledge of complex medical issues, particularly orthopedic and neurological. Understanding of etiology, causation and treatment of injuries consistent with motor vehicle accidents.
Experience with Microsoft Office (Word, Windows, and Excel)
A strategic thinker who is able to develop goals and initiatives and execute on the same.
Bachelors Degree in Business Field or Equivalent experience.