Major Case Commercial General Liability Claim Representative

Claims Position

Under general supervision, this position is responsible for investigating, evaluating, reserving, negotiating and resolving assigned serious and complex General Liability claims. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, litigation management, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. Provides consulting and training and serves as an expert technical resource to other claim professionals, business partners, customers, and other stakeholders as appropriate or required. This position does not manage staff.

• Claim Handling:
• Directly handle assigned severe claims when Travelers has coverage of $2 million or less and file exposure is greater than $500,000.
• Provide quality customer service and ensure file quality, timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case.
• Consult with Manager on use of Claim Coverage Counsel as needed.
• Directly investigate each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Interview witnesses and stakeholders; take necessary statements, as strategically appropriate.
• Complete outside investigation as needed per case specifics.
• Utilize evaluation documentation tools in accordance with department guidelines.
• Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis.
• Utilize diary management system to ensure that all claims are handled timely. At required time intervals, evaluate liability and damages exposure.
• Establish and maintain proper indemnity and expense reserves.
• Recognize and implement alternate means of resolution.
• Manages litigated claims.
• Develop litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers.
• Attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
• Update appropriate parties as needed, providing new facts as they become available, and their impact upon the liability analysis and settlement options.
• Recognize cases, based on severity/complexity protocols, that should be transferred to another level of claim professional and refer on a timely basis.
• Evaluate all claims for recovery potential; directly handle recovery efforts and/or engage and direct Company resources for recovery efforts.
• May assist underwriting business partners in marketing and account contact efforts.
• Attend and/or present at roundtables/ authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expense.
• Share experience and deep knowledge of creative resolution techniques to improve the claim results of others.
• Leadership:
• Actively provide mentoring and coaching to less experienced claim professionals to increase the technical expertise and improve bench strength.
• Communication/Influence:
• Provide guidance to underwriting business partners with respect to accuracy and adequacy of, and potential future changes to, loss reserves on assigned claims.
• Recommend appropriate cases for discussion at roundtable.
• Other Accountabilities:
• Apply "advanced" litigation management through the selection of counsel, evaluation and direction of claim and litigation strategy
• Track and control legal expenses to assure cost-effective resolution.
• Appropriately deal with information that is considered personal and confidential.
• Fulfill specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC) instructions and inquiries from agents and brokers.
• Represent the company as a technical resource; attend legal proceedings as needed, act within established professional guidelines as well as applicable state laws.
• Share accountability with business partners to achieve and sustain quality results.
• May be responsible to research and evaluate current information regarding trends in the law; digest and communicate this information to other Company departments and divisions to assisting underwriting and management decisions.
• May participate in periodic file quality reviews.
• In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements.
• Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
• Perform other duties as assigned.