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National Indemnity Company · 2 months ago

Claims Examiner II

Omaha, NE

Full-time

Onsite

Entry Level

1+ years exp

NICO National Indemnity Company is a member of the Berkshire Hathaway group of Insurance Companies, offering a friendly and stable work environment. The role involves investigating, evaluating, and resolving property damage and bodily injury claims while ensuring compliance with applicable laws and insurance contracts.

Financial ServicesInsurance

Responsibilities

Investigate assigned claims reported under insurance contracts provided by affiliated Companies, including identification of information and documents needed to evaluate claims, assignment and direction of independent adjusters and review of public and other records and documents. Contact Insureds, Claimants and others by telephone and correspondence regarding information and documents necessary to evaluate and resolve claims, claim processes and related matters, and resolution alternatives. Comply with claims handling laws and regulations. At higher levels, may engage defense counsel as directed and monitor defense of Insureds in consultation with management as necessary or may work directly with internal legal counsel

Identify, evaluate and, in consultation with management as necessary, analyze and determine respective rights and obligations of Company, Insured, Claimants and others under insurance contracts applicable to assigned claims. Comply with laws of applicable jurisdiction. Coordinate with Legal Department on coverage, claims handling compliance, and other legal issues

Analyze, evaluate, and estimate liability of Insureds and loss of Claimants/Insureds for assigned claims and identify all potential losses to which Companies’ contracts of insurance apply. Identify and report potential fraud to Special Investigation Unit. Trains on and uses decision theory principles to evaluate various claim settlement scenarios in the settlement process

Establish and timely modify appropriate case reserve reflecting available information regarding assigned claims. Review and approve or disapprove invoices from independent adjusters and others for allocated loss adjustment expenses. Maintain and timely review diary of assigned claims. Negotiate and resolve assigned claims within established authority or submit authority request and recommend resolution to manager

Prepare and maintain accurate and timely record of communications with Insureds, Claimants, and other third-parties; review, establish and modify appropriate units reflecting potential loss exposures; maintain appropriate Claim File including all required electronic and other records and provide information regarding assigned claims to manager and others as required

Obtain and maintain all required licenses and certifications; maintain current knowledge of insurance and claim management principles and practices through review of published opinions, trade periodicals and other professional literature and conferences

Qualification

Insurance claim proceduresLoss evaluation methodsNegotiationInvestigationEvaluationAnalysisCase managementResearchTime managementCommunicationConfidentialityAttention to detailTeamwork