Property Claim Senior Adjuster

For more than 85 years, American Family Insurance has built its reputation on sound principles. We strive to provide you industry-leading service, exceptional claims experience and products that build long-term relationships. This is accomplished by treating policyholders fairly in a helpful and caring way and making it easy and convenient to work with us. We know our customers like family.

The Property Claim Field Senior Adjuster position supports the Claim Division goal of ensuring customer service industry leadership and partners with agency to deliver seamless claim service. An experienced adjuster who has achieved mastery in and performs all areas of property claim adjustment activities with the highest degree of competency and independence. Processes complex or highly complex property field claims that require on-site inspection on a routine basis. Evidences effective performance in the areas of customer, agency and public relations; and is active and competent in conducting training of new claim personnel. Estimating Loss & Damages (20%) * Gathers information via on-site inspections, and researches via phone and internet to determine replacement costs for both structure and contents. Complete building inspections meeting OSHA guidelines. * Prepares accurate estimates by utilizing electronic estimating tools and systems, replacement research results and finally contractor data to establish fair and competitive pricing within Fair Claims Acts. * Determines when to repair or replace structural and personal property loss items dependent on careful review of factors involved. * Sets reserves and recommends settlement values when loss exceeds authority. * Completes factual reports in a timely manner with company corporate standards and state regulations. * Maintains and controls additional living expense exposure. Investigation (15%) * Investigates cause and origin of claims by contacting the appropriate parties including insureds, claimants, agents, attorneys, contractors, other adjusters, public personnel, etc. Checks for prior claims and recognizes environmental exposures. * Coordinates others to assist with complex issues such as court interpretations, structural design and mold. Assistance may be sought from Legal, company personnel, and experts, e.g. engineers. * Recognizes pertinent issues and formats questions to obtain recorded or written statements to properly resolve the assigned claims. Handles claims on a good faith basis. * Recognizes when to secure public documents to complete a claim file investigation. Secures, preserves and maintains evidence in a legal manner. * Recognizes and investigates losses involving subrogation and salvage potential. Uses knowledge of third party and tort liability. * Investigates fraud files and handles complex fraud files. Involves and coordinates investigation with SIU (Special Investigations Unit) when necessary. Policy Determination & Analysis (15%) * Interprets and determines policies and contract coverages and applies to all parties for assigned losses. Interprets claim history coverages. Selects proper loss codes based on policy type.Identifies state-specific legislation and legal precedent based on prior legal cases for assigned geographical area. Seeks assistance as needed. * Utilizes company Claim Bulletins, manuals and best practices. Demonstrates knowledge of underwriting guidelines, inspects risks and makes recommendations to the Underwriting Department as needed. * Applies decision making process to available data to determine extent of coverage or non-coverage and communicates results to appropriate parties. Negotiation, Settlement (15%) * Handles claim negotiations by settling and providing the best customer experience in the industry. * Provides a clear explanation of the estimate to the customer, answers all questions and processes the claim payment. * Recognizes the need for and obtains non-waiver as needed. Recognizes the need for and sends Reservation of Rights letters. * Recognizes, controls and resolves disputes with tact and diplomacy. Notifies or directly involves the agent in the dispute resolution. Utilizes arbitration, appraisal and alternate dispute resolution as needed. Recognizes when assistance is needed and obtains it. File Management (10%) * Actively manages individual claim inventory and works toward meeting cycle-time goals for closing files. Claim inventory will focus on complex and highly complex claims that require on-site inspection, face-to-face contact with customers, and HRP (Homeowner Repair Program) reinspections. Maintains a mobile office for settling claims. These claims include but are not limited to structure damage, smoke, water and fire losses that require extensive investigation due to complex coverage issues, fraud indicators, involvement of public adjustors or need for specialty vendors (engineers, independent medical exam, etc.) * Utilizes the electronic integrated claim system to complete and document actions throughout the life of the file. * Conducts initial review of claims received to identify prior actions taken (e.g. services provided by the Customer Care Center and appointments scheduled) and determine next steps. * Contributes to the team environment by assisting with claims from other adjusters' inventories in the adjustors' absence. Responds to customer inquiries, makes appropriate decisions and closes file as needed. * Assists with claims from desk adjusters when on-site inspections are required. * Makes independent decisions and self-supervises most files but recognizes when assistance is needed. Maintains a global view of the property claim workflow in order to provide customers with appropriate, accurate and timely information throughout the life cycle of their claim. Agency Relationship (10%) * Establishes rapport with agents and builds on-going relationships by including agents in the claim handling process as appropriate. * Partners with agency to provide seamless customer service. Jointly identifies opportunities for process improvements and establishes and implements action plans to address them. * Facilitates communication between customers, agents, vendors, third party administrators and other employees. Proactively provides agents with important claim related information; provides all parties with claim process and status as appropriate; answers questions or redirects to other areas. * Explains and discusses any circumstances that may affect customer service with agency, vendors, third part administrators or other claim personnel. Includes agents in problem resolution as appropriate. * Provides agents with claim handling information via phone conversations, office visits or presentations at district meetings. Training/Additional Assignments (10%) * Conducts effective training for Claims personnel, agents and others as required. * Participates in claim committee meetings and claim-related projects as needed. * Performs disaster claim duty as necessary. * Serves as mentor to lower level adjusters on all aspects of file handling. * Serves as expert resource for lower level adjusters on policy interpretation and analysis. HRP & Vendor Programs (5%) * Understands and explains the HRP (Homeowner Repair Program) and other vendor programs to insureds and claimants. * Develops relationships with HRP contractors and content-replacement and specialty vendors. Maintains contacts during the life cycle of the file. * Conducts HRP contractor reinspections. * Processes payments to HRP contractors.

Job Competencies: * Achieve Results * Be Accountable * Maximize Customer Experience * Conflict Resolution * Information Gathering * Negotiation * Planning & Organizing * Technical Expertise Specialized Knowledge and Skills requirements: * Demonstrated ability to efficiently and effectively handle simple to moderately complex property claims. * Demonstrated deep understanding and skill related to each phase of the property claim handling process. * Flexibility to work nontraditional hours. * Thorough understanding of policies and endorsements related to property coverages. * Valid driver's license required plus an acceptable driving record. Physical Demands: * This position requires the ability to climb or balance between 1 and 33% of the time. * This position requires the ability to work with distance vision (clear vision at 20 feet or more) for extended periods of time (applies to field position only). * This position requires the ability to stoop, kneel, crouch or crawl between 1 and 33% of the time. * This position requires the ability to lift up to 50 pounds between 33 and 66% of the time (applies to field position only).