Key responsibilities
- Investigate loss facts, coverage, damages, liability, and prior claim history to determine whether and how the policy responds.
- Set, revise, and explain reserves using claim severity, coverage, medical or repair information, and jurisdictional exposure.
- Negotiate settlements within delegated authority while documenting rationale, policy language, and customer communications.
- Coordinate appraisers, independent adjusters, repair networks, medical reviewers, defense counsel, and subrogation teams to move the file toward resolution.
- Identify fraud, subrogation, litigation, coverage, and complaint risk early enough to route the file to the right specialist.
- Maintain a claim file that can survive quality audit, market-conduct exam, litigation discovery, and internal leakage review.