Bachelor's degree in a related field or equivalent work experience.
3+ years of Personal Injury Protection (PIP)/No-Fault auto claims handling experience, with coverage interpretation and liability assessment in NY and NJ.
Experience coordinating with outside investigators, client teams, and counsel, including handling arbitration processes.
Strong knowledge of subrogation/risk transfer concepts, reserve setting, and loss reporting.
Requirements:
Review and interpret coverage, process, and conclude assigned PIP claims, including investigation and evaluation of Auto and/or General Liability Casualty Claims in NY and NJ; respond to PIP arbitration proceedings.
Oversee and direct outside investigative service providers; coordinate with the client and client counsel to advance claims to resolution.
Maintain an ongoing diary; continually assess exposure and develop accurate reserve and settlement recommendations; prepare loss reports with thorough analysis of coverage, liability, and damages.
Identify subrogation and/or risk transfer opportunities and initiate recovery efforts; document all correspondence, reports, discussions, and decisions in the claim file; provide outstanding service to the client.
Job description
SUMMARY: Responsible for the prompt review of policy information to determine coverage for loss/damage/injury. Conduct an efficient claim examination and investigation leading to the final resolution of liability claims, including matters in litigation. Frequent contact and interaction with involved parties including claimants and their legal representatives will be required. Recommendations regarding loss exposure and associated reserve and settlement strategy will be effectively communicated to the client. DUTIES AND RESPONSIBILITIES: Review and interpret coverage, process, and conclude assigned Personal Injury Protection (PIP) claims including investigation and evaluation of Auto and/or General Liability Casualty Claims in the jurisdiction of NY and NJ. Respond to PIP Arbitration Proceedings Oversee and direct outside investigative service providers and work closely with the client and client counsel and investigative services to advance the claim to conclusion. Maintain an ongoing diary. Continually assess exposure and evaluate accurate reserves and settlement recommendation. Prepare Loss Reports providing thorough analysis of coverage, liability, and damages. Where applicable, determine if subrogation and/or risk transfer exists and initiate recovery efforts in the direction of the client. Document all correspondence, reports, discussions, and decisions in the claim file record.
