Senior Claims Adjuster - Expert en sinistre principal

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IF YOU CARE, THERE’S A PLACE FOR YOU HERE

EFI Global is a full-service engineering, fire investigation, environmental, health and safety, and specialty consulting services firm serving a variety of industries in both the public and private sectors. Over the last four decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a recognized global leader in engineering failure analysis, origin-and-cause investigations, environmental consulting, laboratory testing and specialty consulting. Our forensic investigation, engineering and environmental services teams around the world share a dedication to expertise, quality and demonstrating to customers that caring counts®. Each of our more than 700 professional engineers, fire investigators, architects and scientists was selected for their technical proficiency, in-depth industry knowledge and commitment to professional integrity. Together, our diverse backgrounds and collective insights empower clients to make better-informed business decisions. EFI’s combination of global solutions and local expertise has earned the firm a reputation for delivering timely responses that consistently meet our clients’ expectations—anytime, anywhere.  Click here to learn more about EFI Global.  

PRIMARY PURPOSE:   To handle losses and claims for property and casualty insurers.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Examines insurance policies and other records to determine insurance coverage.

• Interviews, telephones, and/or corresponds with claimant and witnesses regarding claim.

• Consults police and hospital records and inspects property damage to determine extent of company's liability and varying methods of investigation according to type of insurance.

• Estimates cost of repair, replacement, or compensation.

• Prepares report of findings and negotiates settlement with claimant.

• Recommends litigation by legal department when settlement cannot be negotiated.

• Attends litigation hearings.

• Revises case reserves in assigned claims files to cover probable costs.

• Assists in preparing loss experience report to help determine profitability and calculates adequate future rates.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES:

• Performs other duties as assigned.

Education & Licensing

• Manages comprehensive desktop investigation of assigned claims while meeting company standards and quality, including obtaining all required loss details and relevant information; determining coverage and validity of claims, and communicating with insured and claimants; preparing reports and negotiating settlements

• Maintains accurate records based on company standards and procedures, using company custom computer systems

• Identifies the need and co-ordination of task assignments utilizing field adjusters

• Reviews and interprets policy wording to confirm and apply coverage of losses

• Accurately and efficiently manages the billing for assigned files, within specified timelines

• Maintains an excellent working relationship with existing clients to further develop business

• Committed to continuous education to keep up to date with all industry and legislative issues and changes

• Enrolled in CIP program

Experience

• 1 to 2 year experience

• Proven adjusting, negotiating skills and analytical skills

• Excellent interpersonal and communication skills

• Advanced computer skills including office, outlook and web-based applications

Skills & Knowledge

• Strong oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Demonstrated commitment to timely reporting

• Strong customer service skills

• Strong interpersonal skills

• Attention to detail and accuracy

• Good time management and organizational skills

• Ability to work independently or in a team environment

• Ability to meet or exceed Performance Competencies

We are committed to inclusive, barrier-free recruitment and selection processes. If contacted for an employment opportunity, please advise Colleague Resources if you require accommodation.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

 

Sedgwick is an Equal Opportunity Employer.