Rosey Clark

· Review the policy and work with underwriters to confirm coverage under the policy

· Obtain statements from insureds, claimants and witnesses in addition to collect police reports and medical records to determine the facts of loss, liability and damages

· Order auto appraisals using various auto appraiser vendors

· Negotiate and settle moderately complex claims, total loss settlements, salvage valuation and salvage recoveries

· Process titles, including documentation, maintain logs, and contact banks/lien holders

· Establish appropriate loss reserves

· Identify potential fraud involving brokers, insureds, claimants and body shops

· Proficient with technology such as Carport, SCA appraisals, geotracking, social media reports, ISO indexing, medical bill review, any other technology used in your daily work, etc.

· Interpret medical reports, review medical billing, evaluate claim value and manage claims process to ensure efficient resolution

· Complete a settlement evaluation using liability and damage information

· Respond to letters of representation and contact plaintiff attorneys to resolve cases

· Assign defense counsel as needed

· Negotiate with claimants and attorneys to settle bodily injury claims within an established range of value

· Protect the interests of the insured and exchange when reviewing, investigating, documenting, evaluating, and settling claims

· Contribute to reduce loss ratio and disposal of cases by applying technical and negotiating techniques Read and interprets reasons for claims

· Conduct official interviews or correspond with claimants, witnesses, request police reports, physicians, or other relevant parties to determine claim settlement, denial, or review

· Study Insured’s policy to determine whether insurance will cover the incident

· Request property damage appraisal

· Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies

· Investigates damages to automobiles and property as necessary

· Follow up with all parties involved in accidents and emergencies to determine the nature of the event

· Consult with legal and medical experts to gain further insight into the claim

· Review all claims to check for any fraudulent or contradictory information

· Log all claim information. Maintain files on all policyholders and claim histories

· Compile all information to arrive at a final decision to accept or reject the insurance claim

· Perform appropriate analysis of material damage losses and valuation of constructed total losses

· Policy interpretation and exposure recognition

· Coverage determination, liability investigation and analysis including comparative Negligence

· Identity and forward files to Subrogation

Total loss Specialist

· The Team Lead in the Total Loss Department

· Document a claim file with notes, evaluations, and decision-making process

· Negotiation and Settlement Guidance

• Negotiate Auto subrogation recoveries with responsible party carriers

• Responsible for filing claims and receiving initial claims

• Assist in the recovery of payments for duplicate coverage, and no-fault claims

• Negotiate, and settle subrogation collection

• Answer inquiries, and coordinates with other departments, insurance adjustors

• Recommend and document the necessary information to close a file

• Manage Subrogation Recovery following review of evidence submitted to Arbitration by participating carriers

• Examination of all means of collections and complete claims investigations to determine third party liability and exposure

• The ability to pursue subrogation against individuals, businesses, and insurance companies.

• Review claims and other information to identify possible third-party responsibilities and initiating appropriate action to recover funds paid for various medical expenses and other costs