Technical Claim Specialist - Casualty
Company: Church Mutual Insurance Company, S.I.
Posted on: November 17, 2023
Technical Claim Specialist - Casualty
Looking to join a vibrant organization that makes a difference? At
Church Mutual, we Stand for Good: Our work is powerful, inspiring
and meaningful because we serve those who serve others. We
specialize in insuring purpose-driven organizations, leading the
way in markets that include nonprofit and human services
organizations, religious institutions of all denominations,
schools, senior living communities, and camps and outdoor
recreation facilities. We foster a workplace where all employees
are treated with dignity and respect. Diversity, inclusion and
belonging are woven into the fabric of our company through our
customers, employees, leadership, business relationships and
What you'll be doing:
Responsible for handling large, complex claim files, including
litigated matters, catastrophic claims, umbrella claims, punitive
damage claims, severe injury, long duration indemnity, permanent
total disability, structural building damage, multiple location
damage, including business income exposure and other extensive
exposure claims, in accordance with applicable state and federal
laws. Set reserves and settle claims within level of authority.
Direct work of defense attorney. Actively share knowledge with team
members, contribute to training programs, and mentor other claim
On any given day, you'll:
I. Perform claim tasks timely and document claim files
appropriately. Proactively manage claim activities to ensure fair
claim resolution. Handle all claims in accordance with state and
federal laws. II. Make complex coverage decisions by gathering
information necessary to make an informed decision in a fair,
equitable, and ethical manner. Deny losses within authority level,
providing detailed explanation, citing facts, and policy language.
III. Perform a thorough investigation based upon the type,
complexity, and severity of the claim. Inspect loss sites as
necessary. Upon completion of the investigation, analyze and
evaluate the potential high exposure and extensive damages,
including potential full or partial liability and compensability
denials. Formulate and document an action plan based on the covered
damages and injuries. IV. Determine and set reserves based on the
most probable outcome of the claim, within authority level.
Evaluate and negotiate directly with insured, claimant, or
claimant's attorney on all cases within authority level. Review
claim facts and exposure with claims management, as appropriate, to
guide claim strategy. Make complete, accurate, and timely payments
within authority for covered losses. V. Maintain a professional,
courteous, and helpful approach when communicating in-person, on
the phone, or through email and other correspondence with internal
and external customers, business partners, and brokers. VI. Provide
knowledge and guidance to other claim handlers regarding claim
strategy, coverage interpretations, and in-depth jurisdictional and
legal nuances. Field questions from team members related to
coverage/compensability decisions. VII. Investigate and refer
identified claims to Loss Recovery Services, as applicable. VIII.
Direct work of defense attorney through collaboration on claim
strategy and resolution. Ensure defense attorney is adhering to
Litigation Management guidelines. Manage claim expense by
concluding vendor assignment when vendor is no longer adding value
to the claim. IX. Engage in direct investigation, control, and
settlement negotiations when outside adjusting and legal services
are not necessary or available. X. Attend mediations, depositions,
and trials. Present complex claim files during roundtables and
claims committee meetings.
Here's what we expect
1. Prior Experience:Eight or more years in technical insurance
claim roles with increasing responsibilities is required. 2.
Education:* Bachelor's degree preferred. A combination of
equivalent education and/or experience may be considered in lieu of
* Evidence of continuing education in the insurance industry is
* Additional legal education or law degree is highly desirable.
* Completion of AIC and/or CPCU is preferred. 3. Necessary
Knowledge and Abilities:* Ability to obtain and maintain state
adjusting license requirements and complete continuing education
* Advanced knowledge of recoveries such as subrogation,
reinsurance, apportionment, and deductibles.
* Advanced knowledge of reinsurance contracts, workers compensation
pools, second injury funds, etc.
* Advanced negotiation skills.
* Strong listening, verbal, and written communication skills.
* Advanced knowledge of policy terminology, legal principles
involving insurance, and emerging industry trends.
* Effective planning and organization skills.
* Ability to travel to inspect loss sites, attend mediations,
Learn about our benefits:
We value your hard work, dedication to our customers, and
contributions to the team - and we understand the importance of
benefits for today and planning for the future. Our generous,
flexible total rewards provide you and your family with security
and peace of mind. View our full total rewards package here
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Keywords: Church Mutual Insurance Company, S.I., Appleton , Technical Claim Specialist - Casualty, IT / Software / Systems , Merrill, Wisconsin
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