Analyzes and controls complex claims, in partnership with management, claims adjusters and litigation specialists to resolve questions of coverage, assess liability and determine settlement amounts using independent judgment.
Controls files and coordinates activities involving first party, third party or workers' compensation bad faith litigation against ERIE for claims involving property or liability, respectively. Reviews files, conducts research, assigns counsel, and manages litigation process.
Coordinates activities with the litigation specialist, claims supervisors, and claims adjusters when legal action is taken.
Directs investigation, settlement, or denial of claims as needed. Directs appeal process and excess verdict claims. Monitors fraud cases.
Reviews first-party, third-party or workers' compensation claims to ensure appropriate file construction, adequate reserves and necessary reinsurance. Audits reserves and reviews claims files for branch offices in assigned area.
Responds to inquiries and/or complaints made to the Office of the President regarding first party claims. Takes appropriate action as necessary.
Reviews files and makes recommendations for improvement as appropriate. Visits field offices on a periodic basis to conduct training and work with staff on better understanding the people and effectiveness of our processes and procedures in the field operations environment.
Collects, analyzes, and prepares reports regarding litigation, first party, third party or workers' compensation claims files for internal use. Monitors results and costs in assigned area.
Assists defense counsel in first party, third party or workers' compensation bad faith litigated claims for property or liability, respectively. Attends pre-trial and trial proceedings to determine whether claim should be brought to conclusion prior to verdict. Directs the litigation specialist, claims supervisor and claims adjuster as required.
Keeps abreast of trends and latest developments in insurance coverage, claims handling and the litigation field, and assists in training of branch claims personnel.
Handles claims complaints and inquiries; takes appropriate action.
Participates or assists with training as needed for the department.
The first eight duties listed are the functions identified as essential to the job. Essential functions are those job duties that must be performed in order for the job to be accomplished.
This position description in no way states or implies that these are the only duties to be performed by the incumbent. Employees are required to follow any other job-related instruction and to perform any other duties as requested by their supervisor, or as become evident.
