PIP ADJUSTER, Casualty Claims                                                       

 

Summary
 Responsible for the fair and accurate disposition of pending personal injury protection and
medical payment claims through investigation, evaluation, settlement or recommendation within
the authority level granted by the Territorial Claims Manager
 

 

Duties
 �         Reviews liability in order to control the company�s exposure:  reviews assigned
claims for PIP and Med Pay policy exclusions such as Workers� Compensation, alcohol, and
criminal intent; identifies possible fraud using established indicators which as prior losses
and severe injuries with no physical damage

�         Identifies and appropriately reassigns potential BI and UM/UD claims

�         Contacts insureds, attorneys, and others in conformance with C.A.R. guidelines to
gather required information: sends lost wage forms to employers and requests disability
statements as required; schedules IMEs and discusses requirements with providers

�         Pays submitted bills according to established procedures

�         Answers questions from insureds, claimants, attorneys, and others, and resolves
problems within established levels of authority

�         Develops and maintains case files that document all actions

�         Provides excellent customer service

�         Performs other activities as required 
 

 

Qualifications
 �         College degree or insurance coursework/experience required

�         Superior organization skills and detail orientation required

�         Customer service experience required

�         Excellent communications skills required

�         Ability to work co-operatively within a team environment