Summary Statement
This position adjusts insurance claims (Automobile and Property & Casualty) for the State of Delaware, its agencies, school districts, higher education institutions, and its employees.
Essential Functions
Essential functions are fundamental, core functions common to all positions in the class series and are not intended to be an exhaustive list of all job duties for any one position in the class. Since class specifications are descriptive and not restrictive, incumbents can complete job duties of similar kind not specifically listed here.
- Performs coverage analysis, investigation, evaluation, negotiation, and deposition of insurance claims for all lines of insurance except health, life and disability managed and paid on behalf of the State of Delaware. This includes conducting research, collecting data, performing investigations, mediating disputes and negotiating claim settlements when appropriate.
- Provides expertise on behalf of the State on insurance programs and other insurance claims questions.
- Makes proper determination of coverage, legal liability, and damages to effect settlement of claims.
- Directs contracted appraisers, investigators, rehabilitation specialists, adjusters, and attorneys in adjudicating claims.
- Prepares Request For Proposals (RFPs) for insurance coverage and other contracted services.
- Researches federal and state statutes and insurance regulations and keeps abreast of new and/or revised pending legislation for potential impact on the State.
- Prepares files with required forms exhibits and reports to assist in litigation management and maintains a working diary for each assigned claim file.
- Maintains records and reports of the self-insurance fund.
- Ensures all subrogation is promptly identified, the responsible party is documented in an automated information system and subrogation letters are sent to responsible parties.
Job Requirements
JOB REQUIREMENTS for Insurance Coverage Officer
- Possession of a Delaware Insurance Adjuster's License in one or more of the following lines of authority: Casualty, Motor Vehicle, Workers Compensation, or Property.
- Six months experience in investigating, evaluating and negotiating insurance claims and making determinations for coverage, legal liabilities and damages affecting the settlement of claims.
- Three years experience in interpreting insurance laws, rules, regulations, standards, policies and procedures.
- Six months experience in narrative report writing.
- Knowledge of medical terminology.
Conditions of Hire
Applicants must be legally authorized to work in the United States. The State of Delaware Executive Branch participates in the Federal E-Verify system where the State will provide the federal government with each new hires Form I-9 information to confirm that you are authorized to work in the U.S. For more information refer to our job seeker resources.
Benefits
To learn more about the comprehensive benefit package please visit our website at https://dhr.delaware.gov/benefits/
Selection Process
The application and supplemental questionnaire are evaluated based upon a rating of your education, training and experience as they relate to the job requirements of the position. It is essential that you provide complete and accurate information on your application and the supplemental questionnaire to include dates of employment, job title and job duties. For education and training, list name of educational provider, training course titles and summary of course content. Narrative information supplied in response to the questions must be supported by the information supplied on the application including your employment, education and training history as it relates to the job requirements.
Once you have submitted your application on-line, all future correspondence related to your application will be sent via email. Please keep your contact information current. You may also view all correspondence sent to you by the State of Delaware in the “My Applications” tab at StateJobs.Delaware.gov.
Accommodations
Accommodations are available for applicants with disabilities in all phases of the application and employment process. To request an auxiliary aid or service please call (302) 739-5458. TDD users should call the Delaware Relay Service Number 1-800-232-5460 for assistance.
The State of Delaware is an Equal Opportunity employer and values a diverse workforce. We strongly encourage and seek out a workforce representative of Delaware including race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression.
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