Risk Auto Claims Specialist
Job Description
Risk Auto Claims Specialist an insurance professional responsible for investigating, evaluating, and settling automobile insurance claims, with a primary focus on identifying and managing high-risk situations, including potential liability issues, large damage claims, and complex legal scenarios; they work to minimize financial losses for the insurance company by making informed decisions based on policy coverage and legal guidelines while maintaining customer satisfaction.
Key Responsibilities:
Claims Investigation: Conduct thorough investigations of auto accident claims by gathering information from within the organization, police reports, medical records, and vehicle damage reports, and other available sources of information.
Liability Assessment: Analyze accident details to determine fault and potential liability in complex cases, considering legal precedents and state regulations.
Coverage Determination: Review insurance policies to assess coverage limits and determine applicable benefits for each claim.
Claim Negotiation: Contribute to settlement negotiations to reach fair and cost-effective resolutions.
Risk Management: Identify high-risk claims early on, implement proactive strategies to mitigate potential losses, and escalate complex cases to appropriate parties.
Litigation Management: Assist Director with claims that proceed to litigation, providing necessary documentation and supporting evidence.
Claims Reporting: Maintain accurate and detailed incident files, documenting all actions taken, communication with involved parties, and progress updates.
Fraud Detection: Investigate suspected fraudulent claims and take appropriate actions to prevent losses