Casualty Specialist
For over 100 years, AAA Insurance Exchange* has had a strong tradition of helping people. We protect dreams and restore lives by delivering member-centric products and a superior claims experience to our members. Our vision is to be the #1 insurer for AAA members across the AAA markets we serve. We provide automobile, homeowners, and other personal lines insurance products to AAA clubs in 23 states and the District of Columbia, and serve more than 17 million AAA members nationwide. We are rated A+ by A.M. Best and earned $2.6 billion in revenue in 2010.
sualty Specialists are responsible for opening, investigating, evaluating and settling casualty claims and ensuring compliance with Department of Insurance and other statutory requirements in multiple states.
Handles 1st party injury cases without Liability injury (Medical Pay, Accidental Death Benefits, High Limits)
Dependent upon level of proficiency, Handles Auto low to moderate complexity 1st and 3rd party injury cases reserved up to 25k. Potentially handles Personal Injury Protection claims. First Priority in First Notice Of Loss queue (approx. 95%). As applicable, may own claims of less complexity when supporting catastrophes.
Handles claims in multiple states
Works in call center environment. External communication completed in writing, by telephone and by electronic means (e.g., e-mail).
Assigned as Owning/Adjuster when injury exposure is identified
Handles simple to moderate 1st and 3rd party auto cases involving injury
Handles 1st party Medical payment and Uninsured Motorists claims including ADB (Auto Death Benefit) claims
Handles liability injury claims
Assists in catastrophes and/or injury phone queue
Potentially handles Personal Injury Protection and Out of State claims
1st Priority in First Notice of Loss casualty queue
Responsible for handling, managing, investigating, negotiating, settling and/or resolving complex claims with exposure valued less than $25,000, with minimal supervision. Duties include, but are not limited to:
Making coverage determinations and advising customers as to proper course of action related to coverage issues
Conducting investigative work of a complex nature (interviewing witnesses; obtaining and analyzing evidence, including medical records; deciding whether an independent medical examination is warranted; etc.)
Making liability determinations
Evaluating potential for subrogation and initiating initial notice of subrogation request
Developing negotiating strategies
Negotiating with claimant or claimants attorneys
Making final decisions to settle within settlement authority, without supervisory approval
Presenting cases in Committee setting when seeking above settlement authority level; thereafter, independently negotiating and settling the claim
Works in an office environment sitting at a desk, table or computer workstation for long periods of time. Approximately 50-80 percent of time spent on the job involves the use of a personal computer and a headset. (Field-based Senior Casualty Specialist may spend over 50 percent of time outside office engaged in activities such as court appearances; on-scene investigations; driving; standing for variable amounts of time inspecting vehicles, taking photos, etc.)
Required:
- Strong analytical, problem-solving and organizational skills
- Strong ability to work independently
- Strong decision making ability
- Strong customer service orientation
- Basic math and computer skills and ability to type 30 wpm
- Proficient oral and written communication skills and good command of the English language
- Ability to function in a team environment
- Ability to successfully complete training courses pertinent to job duties
- Developing understanding of statutory and regulatory requirements
- Developing understanding of AAA claims policies and procedures preferred
- Ability to travel on rare occasions
- Ability to work extended hours and/or weekends
Required:
- BA/BS in business, insurance or related area, or equivalent combination of education and experience
Preferred:
- 2-3 years of claims experience
- Bilingual a plus
*The legal name of the Company is AAA Northern California, Nevada Utah Insurance Exchange
