Property Claims Examiner

Property Claims Examiner
November 28, 2018 dtric2

DTRIC Insurance is looking to fill two (2) positions for the Property Claims Examiner.

Primary Responsibilities:  Manages, investigates and resolves residential and commercial property losses of varying exposure and complexity, within assigned authority level (up to or more than 100,000) with minimal to direct supervision and more complex losses under general direction of Claims Manager or Supervisor. Completes field investigations and property damage estimates.  Evaluates and analyzes coverage issues of varying complexity and recommends resolution as necessary with minimal supervision.  Completes Large Loss reports per company guidelines. Identifies potential subrogation opportunities that maximize the company’s recovery of paid losses.

Essential Functions:

  1. Answers telephone calls and makes outbound calls in response to first notice of loss reports, investigation of losses, claim status inquiries and other miscellaneous items from policyholders, claimants, insurance agencies, and other business associates.
  2. Determines proper policy coverages and applies best claims practices in accordance with company guidelines. Applies understanding of insurance policies to establish coverage and/or estimates based on investigations/findings.
  3. Investigates loss including obtaining recorded statements of policyholders, claimants, and witnesses; review of police/fire reports, accident reports, witness statements; and conducting field investigations. Makes decisions within designated authority. Follows high standards of professional conduct while providing delivery of superior claims service.
  4. Corresponds both orally and in writing with policyholders, claimants, witnesses, attorneys, insurance agencies and other business associates to: investigate the loss, determine coverage (1st party and liability) and report findings to relevant parties, including the drafting of appropriate reservation of rights (ROR) and declination of coverage letters, for approval by Claims Supervisor or VP Claims.
  5. Draft Large Incurred Reports for approval by Claims Supervisor or VP Claims.
  6. Performs inspection of residential and commercial property losses of varying exposure and complexity and completes detailed estimates as required utilizing estimating software, i.e. Xactimate.
  7. Opens, closes and adjusts reserves in accordance with company practices designed to ensure reserve adequacy.  Recommends large reserves where necessary in accordance with company guidelines. Obtains necessary information from insured’s, expert’s, contractor’s etc. to fully and accurately assess loss.   Enters data into computer system including claim file activity notes, case evaluation, reserve assessment and plan of action to bring case to resolution.
  8. Resolves coverage or unusual questions within designated authority. Conducts related research and collaborates with coverage counsel as necessary.
  9. Establishes and manages diary dates and tasks on all open electronic claim files through claim resolution.
  10. Evaluates investigation material, expert report, police/fire report, damage appraisal report, recorded statement transcripts and other sources of information to determine insured’s liability and authorize or deny payment.
  11. Identify fraud and subrogation opportunities.
  12. Plan and participate in CAT (catastrophe) Team during core and non-core work hours.
  13. Works with and may coordinate with various vendors such as contractors, emergency repair, cleaning and replacement services.
  14. Manage files that go to Appraisal or litigation.
  15. Completes investigation task referrals by in-house personnel.
  16. Performs other duties as may be required or assigned by Claims Supervisor or VP Claims.

Minimum Qualification Requirements:

Skills/Knowledge: 

  1. Requires knowledge of property/casualty insurance claim processes and coverage evaluation skills.
  2. Requires good knowledge of customer service and oral communication skills.
  3. Requires good PC skills including spreadsheet and word processing applications.
  4. Requires a high level of property damage evaluation and estimating skills, including residential and commercial construction knowledge, fire and water damage restoration knowledge, and the ability to evaluate business income losses.
  5. Requires good math skills to add, subtract, multiply, divide and calculate percentage changes.
  6. Proficiency with PC applications including, Microsoft Office, experience with estimating programs (Xactimate) preferred.

Education/Experience: 

  1. 0 – 5 years Property and Casualty claims adjusting experience.
  2. 0 – 5 years handling residential and commercial property losses of varying exposure and complexity, including damage estimating experience; expected to learn to write estimates using software, i.e. Xactimate.
  3. Bachelor’s degree preferred, and/or equivalent combination of education and experience directly related to the functions and requirements specified.
  4. Active State of Hawaii Independent Adjusters License preferred.
  5. Requires current and valid Driver’s License with clean driving record and access to a vehicle.

*Multiple grade levels available for this position, based on background and experience.

As a DTRIC team member, you’ll enjoy a competitive salary, paid vacation and holidays, medical and dental coverage, a 401(k) plan with employer contribution, preferred insurance rates and more.