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Plymouth Rock Assurance · 1 day ago

Senior Claims Representative, Bodily Injury

Parsippany, NJ

Full-time

Onsite

Senior Level

$88K/yr - $112K/yr

5+ years exp

Plymouth Rock Assurance is a leading company in personal and commercial auto and homeowner’s insurance. They are seeking a Senior Claims Representative to handle First- and Third-Party Bodily Injury claims, conducting investigations, managing vendors, and negotiating claims while adhering to legal and regulatory guidelines.

Auto InsuranceFinancial ServicesInsurance

H1B Sponsor Likely

Responsibilities

Initiate prompt contact of all insureds/claimants/witnesses on all new claim assignments to conduct thorough coverage and liability/injury investigations. These investigations might require the representatives take in depth recorded statements to investigate coverage and liability/injury claims

Analyze, review and interpret policies to assess coverage and liability. Provide advice to Excess and Primary coverage issues

Conduct field investigations, interviews with insureds, witnesses and claimants while maintaining a pending of represented and unrepresented claimant cases

Manage and direct outside vendors (Field/Counsel/Surveillance, etc.) to determine what investigation is necessary and give them direction to bring a claim to conclusion. Ensure only necessary work is completed

Investigate cases timely so that reserves are established and maintained at proper levels. Revise reserves timely based on developments in the course of the claim

Investigate the validity of bodily injury claims being presented by individual insureds/claimants or attorneys representing insureds/claimants. Be aware of certain “Red Flags” to identify potential fraudulent claims. Refer to SIU for investigation timely

Handle complex claims to include coverage issues, UM/UIM, TNC, Commercial, Umbrella etc. Also, must have prior litigation handling

Recognize and investigate subrogation potential

Negotiate both 1st and 3rd party claims directly with injured parties and/or their attorneys

Exercises proper judgment and decision making to analyze exposure, determine the proper course of action and make recommendations for final resolution

Attend litigation proceedings to either represent the company or participate in arbitrations/depositions/settlement conferences/ mediations/ trials

Attend all internal and external training events as required

Participate in proactive team activities to achieve departmental and company objectives. May be asked to participate in special projects, committees or assignments from management

Utilize all claims systems, Excel, Word and social media search engines

Prepare case summary for significant reserve increase and/or trial alerts. Participate in roundtable discussions

Effectively manage workload while maintaining diary and focus on claims quality

Possess knowledge of and adherence to State(s) laws and regulatory claim handling guidelines and statutory regulations

Adhere to departmental internal control requirements. Comply with Plymouth Rock’s standards, best practices and ethical guidelines, adhere to Plymouth Rock’s culture

Qualification

Bodily Injury Claims HandlingLitigation KnowledgeNegotiation SkillsInsurance Regulations KnowledgeClaims InvestigationSubrogation KnowledgeCustomer Service SkillsMedical TerminologyExcel ProficiencyWord ProficiencyCommunication SkillsOrganizational SkillsTime Management SkillsProblem Solving SkillsSelf-Motivation

Required

A bachelor's degree (B.A.) from an accredited four-year college or university

5 - 10 years' experience handling liability commercial, homeowners, UM/UIM, Excess/Umbrella

In-depth knowledge of litigation, arbitration and trial process, handle out of state claims, and/or Personal Injury Protection claims

Currently holds and/or can readily obtain an out of State License(s) (i.e. - CT, Delaware, Florida, etc.)

High level of self-motivation

Have advanced skills in coverage, investigation, litigation/ legal issues, negotiations, evaluations, medical terminology, and subrogation

Strong communication, organizational, customer service and time management skills

Excellent problem solving skills

Possess knowledge of and adherence to State(s) laws and regulatory claim handling guidelines and statutory regulations

Preferred

Professional designation such as IIA, AEI, Senior Claim Law Associate (SCLA) or Chartered Property Casualty Underwriting (CPCU) or be actively working towards a designation

Benefits

4 weeks accrued paid time off + 9 paid national holidays per year, and 2 floating holidays

Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)

Annual 401(k) Employer Contribution

Free onsite gym at our Woodbridge Location

Resources to promote Professional Development (LinkedIn Learning and licensure assistance)

Robust health and wellness program and fitness reimbursements

Various Paid Family leave options including Paid Parental Leave

Tuition Reimbursement

Company

Plymouth Rock Assurance

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Founded in 2001

Boston, Massachusetts, USA

1001-5000 employees

https://www.plymouthrock.com

H1B Sponsorship

Plymouth Rock Assurance has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (11)

2024 (12)

2023 (6)

2022 (7)

2021 (5)

2020 (12)