Clams Representative

  • Pennsylvania Lumbermens Mutual Insurance Company
  • Philadelphia, PA, USA
Full Time Claims

Job Description

Reports To: Casualty Claim Manager


Position Summary: Manage and direct the resolution of a caseload consisting of low complexity, high volume commercial property and casualty claims. This position interprets policies to confirm coverage, selects and assigns external experts and independent adjusters, determines the amount of loss and negotiates settlements within a specific range of assigned claim reserve and payment authority.


Essential Functions and Responsibilities:

  1. Promptly contact insureds, claimants and brokers to acknowledge receipt and assignment of new claims
  2. Confirm coverage and establish claim reserves within assigned monetary authority.
  3. Assign independent adjusters and other experts to investigate losses and follow through to completion of investigation. 
  4. Analyze investigative facts and determine liability in third party claims
  5. Evaluate all pertinent data on a claim to establish fair settlement range.
  6. Negotiate settlements and/or ACV of property.
  7. Issue Risk Alerts for specific underwriting hazards.
  8. Alert claim management to high exposure claims with potential to exceed reserve authority. 
  9. Recognize indicators of fraud.
  10. Settle claims within assigned payment authority on a timely basis.
  11. Investigate subrogation potential and follow through to completion.


Knowledge and Skills:

  1. 4-Year college degree preferred. 
  2. Minimum 2 years prior commercial claims adjusting experience.
  3. Working knowledge of coverage and claim investigation techniques.
  4. Basic MS Office skills.
  5. Strong oral and written communication skills.
  6. Attainment of adjuster licenses in required states (or willingness to attain upon hire).
  7. Strong organizational skills
  8. Ability to professionally interact with wide variety of different personalities.  
  9. Ability to handle difficult situations calmly and rationally.


Physical Requirements:

  1. Ability to hear.
  2. Ability to speak clearly.
  3. Ability to sit for extended periods of time.  

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