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Complex High Exposure Claims - Auto


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Join a team of diverse professionals at Farmers to acquire skills on the job and apply your learned knowledge to future roles at Farmers. Farmers Insurance also offers extensive training opportunities through the award winning University of Farmers named by Training magazine amongst top 10 corporate training units in the world.

Job Summary

Experienced Claim Owner who proactively investigates, confirms coverage, determines liability, evaluates damages, and negotiates settlement of auto physical damage and bodily injury claims, which include Auto, Homeowners liability, and Umbrella losses with complex and catastrophic exposures including but not limited to those in excess of $150,000 requiring in depth investigation, analysis, evaluation, and negotiation skills. Maintains ownership of claim through resolution of all exposures. Serves as the primary point of contact for customers throughout the claims process. Communicates and collaborates with other claim specialists and defense counsel to facilitate claim resolution for customers.

Essential Job Functions

Makes same day contact with customers. Explains the claims process to all customers. Explains all applicable coverage benefits to the policyholder. Confirms facts of loss. Determines vehicle location and if drivable. Offers vehicle repair and rental service options to customers. Arranges for auto physical damage estimate through proper method of inspection. Arranges for release of vehicles that are accruing storage fees. Arranges for in person meeting with injured unrepresented claimants based on the needs of the claim. Investigates and determines coverage for Auto, Homeowners and Umbrella policy claims with complex coverage issues requiring in-depth investigation, policy interpretation, and knowledge of state statues and case law. Determines if the policy is in force for the date of loss, if the driver is an insured on the policy, if the vehicle is a covered auto, if any exclusions or endorsements apply to the loss, and what coverages on the policy apply to the loss. Provid es verbal and written communication to customers to explain coverage issues and decisions. Prepares and authorizes appropriate coverage correspondence including Reservation of Rights and Disclaimer letters within prescribed authority levels. Communicates policy risk issues with Underwriting to facilitate their evaluation of the policy risk and exposure. Conducts material misrepresentation investigations and submits findings to Underwriting. Investigates and determines liability for claims requiring in depth investigation and analysis including multi vehicle auto losses with comparative negligence and homeowner’s liability losses. Completes investigation by securing recorded statements of the parties, police report, vehicle photos and estimates, scene investigations, and other supporting evidence. Authorizes retention of experts when necessary to determine liability. Analyzes duties owed and breached by all potential responsible parties and determines liability percentage for each party. Communicates liability decision to customers, claimants, claim specialists, and Underwriting. Recognizes subrogation potential and makes referrals to Subrogation department when appropriate. Investigates and recognizes all potential claim exposures. Investigates and evaluates injury exposures for all alleged injury claims. Escalates claims with exposures exceeding financial authority to Manager. Resolves auto physical damage claims proactively and accurately. Secures estimate of damages timely through appropriate repair channel. Issues and authorizes claim payments to customers and repair facilities. Explains repair process and estimate to customers. Manages rental claims through communication with customers, repair facilities, rental vendors, and claim specialists. Proactively manages and mitigates storage costs. Coordinates and collaborates with auto physical damage and total loss specialists to facilitate claim resolution for customers. Resolves complex a nd catastrophic injury claims proactively and accurately. Types of injury exposures handled include but are not limited to exposures exceeding $150,000, and/or allegations of death, permanent paralysis, brain injury, loss of limb, loss of senses, and significant burns. Completes injury investigation by securing recorded statements of injured parties, meeting in person with injured parties as necessary, obtaining signed medical authorizations, and requesting medical bills and records. Authorizes retention of experts when necessary for injury evaluation. Analyzes and evaluates injury causation for all alleged injuries. Evaluates bodily injury claims early and throughout the life of the claim including assessment of medical damages, wage loss, and general damages. Evaluates, sets, and updates case reserve amount for all injury exposures throughout the life of the claim. Prepares large loss notifications for senior management employees within the Claims, Product, and Underwriting departments. 

Physical Actions

Sits or stands for extended periods of time, up to a full work shift. Occasionally reaches overhead and below the knees, including bending, twisting, pulling, and stooping. Occasionally moves, lifts, carries, and places objects and supplies weighing 0-10 pounds without assistance. Listens to, interprets, and differentiates auditory information (e.g. others speaking) at normal speaking levels with or without correction. Visually verifies and reads information. Visually locates material, resources and other objects. Ability to continuously operate a computer for extended periods of time, up to a full work shift. Physical dexterity sufficient to use hands, arms, and shoulders repetitively to operate keyboard and other office equipment up to a full work shift.

Physical Environment

This position operates in an open office working environment which will include normal and customary distractions, noise, and interruptions.

Education Requirements

High School diploma or equivalent required. Bachelor's degree preferred. Completion of, or actively pursuing a major insurance designation, or actively pursuing insurance related courses.

Experience Requirements

5-7 years prior injury claims adjusting and/or injury claims supervisor work experience, or equivalent experience required. Advanced customer service and communication skills. Able to communicate with customers on matters of sensitivity and significance. Advanced critical thinking, time management, analytical, and negotiation skills. Advanced coverage, liability, evaluation, and litigation technical skills including knowledge and interpretation of local statutes and case law. Proficient in use of computer, internet, and Microsoft office applications.  Claim handling experience in California, Washington, Oregon, Nevada, Utah or Arizona is preferred but all interested candidates are encouraged to apply.

Job Location(s): US - CA - Carlsbad, US - CA - Remote, US - AZ - Remote, US - NV - Remote, US - CA - WdlndHills-6301, US - ID - Remote, US - UT - Remote, US - CA - Burbank, US - CA - Ontario, US - MT - Remote, US - CA - Brea, US - CA - Concord, US - CA - Daly City, US - CA - Oakland, US - CA - Orange, US - CA - Sacramento, US - CA - San Bernardino, US - CA - Santa Rosa, US - CA - Torrance, US - CA - Ventura-Telephn, US - CA - Westlake Village, US - AZ - Mesa, US - AZ - Scottsdale, US - AZ - Tucson, US - CA - Fresno, US - CA - Glendale, US - CA - Pasadena, US - CA - Riverside, US - CA - San Francisco, US - CA - SanJose-Saratga, US - CA - WoodlndHil-Cnga, US - AZ - Flagstaff, US - AZ - Kingman, US - AZ - Lake Havasu City, US - CA - Bakersfield, US - CA - Calabasas, US - CA - Citrus Heights, US - CA - Northridge, US - CA - Rancho Cordova, US - UT - Salt Lake City, US - UT - Sandy, US - AZ - Yuma, US - CA - Agoura Hills, US - CA - Merced-87 W, US - CA - Modesto, US - CA - Santa Ana, US - CA - SimiVly-Cochran, US - CA - Visalia, US - UT - Ogden, US - AZ - Prescott, US - CA - Alameda-1751, US - CA - Brea-Imperial, US - CA - Chico, US - CA - Irvine-1920Main, US - CA - LA-Flower, US - CA - La Mirada, US - CA - Manteca, US - CA - Martinez, US - CA - Milpitas, US - CA - Pleasanton, US - CA - Pomona, US - CA - Rancho Cucamong, US - CA - Redlands, US - CA - Roseville, US - CA - Salinas, US - ID - Boise, US - MT - Billings-27thSt, US - MT - Missoula, US - NV - Henderson, US - NV - LsVgas-TownCtr, US - NV - Reno-Virginia, US - UT - American Fork, US - UT - Riverdale, US - UT - Sandy-Monroe, US - UT - St. George, US - UT - West Valley, US - CA - Monrovia, US - CA - Rancho Mirage, US - CA - SanDiego-A St, US - CA - Santa Maria, US - CA - Stockton-March, US - CA - Union City, US - ID - Meridian

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Nearest Major Market: San Diego

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