Claims Adjuster or Senior Claims Adjuster

The Michigan Property & Casualty Guaranty Association (“MPCGA”) is an unincorporated association of all property and casualty insurers authorized to transact insurance in Michigan.  The MPCGA was created by an act of the Michigan Legislature, ‘MCL 500.7901’ et seq., in order to protect the public against financial losses to policy holder and claimants as a result of property and casualty insurance company insolvencies. When a member insurer becomes insolvent, MPCGA has a duty to pay certain obligations of the insolvent insurer that come within the Act’s definition of covered claims. MPCGA does not handle claims arising out of life or disability insurance or annuity contracts.

MPCGA is looking for a Claims Adjuster or Senior Claims Adjuster possessing multi-line experience. We are primarily looking for a candidate with strong Workers’ Compensation claims handling experience. The ideal candidate would possess claims knowledge in Workers’ Compensation, Personal Injury Protection, and/or General Liability including residential and commercial claims experience for claims handled in the State of Michigan.

The Job Duties and Qualifications:

5+ years of claims adjusting experience in the workers compensation field or combined with PIP/Liability experience.

Bachelor’s Degree preferred in a business-related field

The Claims Adjuster may handle multiple types of claims. Ensures claims presented are handled appropriately by reviewing all necessary records, laws and information to provide appropriate coverage available within the policy while applying any applicable limits of coverage outlined in the policy and statutes in accordance with the MPCGA Act.   Ensures claims investigation and processing are conducted under state laws and regulations including subrogation and recovery efforts.  Handles and resolves claims according to type of insurance, including corresponding with claimant and/or counsel, works with Nurse Case Managers, review of medical records, retention of expert witnesses and determining the ultimate exposure of each claim. Provides direction on litigated matters.

The Senior Claims Adjuster will investigate and administer claims against policies of insurance written in Michigan for the protection of residents in accordance with the MPCGA Act, and attempts to resolve through out-of-court settlement with the claimant and/or counsel. Handles more complex claims based on coverage, appraisal, and verifiable damage. Examines claim forms and other records to determine coverage and request any second injury fund reimbursement. Responsible for corresponding with claimants, witnesses, and attorneys to gather important information to support contested claims including investigating subrogation and handling recovery efforts. Analyzes police and hospital records; and determines extent of company’s liability and varying methods of investigation according to the type of insurance. Reviews reports from Nurse Case Managers and works with them.  Prepares report of findings and negotiates settlement with claimant.

Computer Skills

Proficient in using Microsoft products such as Word, Excel, Outlook and MS Teams. Having some knowledge in utilizing claims systems. The candidate will work from the office and at home. The ideal candidate must be proficient and able to work from home having online capabilities. The candidate will be required to report to the office for the first 6 months.

Certificates, Licenses, Registrations:

Our Adjusters are required to be licensed in the State of Michigan to perform the job functions and MPCGA will assist and pay for the license including renewal each year.  If the candidate does not have an adjuster’s license in the State of Michigan, the candidate must obtain the license within the first 6 months of employment as conditional for continued employment. Designations of CPCU and AIC are desired but not required.

Benefits:

We offer a competitive salary matching experience, 401(k) match, 401(k) enhancement potential, health, dental, vision, vacation, holidays, sick leave, service recognition, bereavement, education assistance, life insurance and short-term disability

Qualified and interested candidates for consideration, submit your resume, salary requirements, cover page with your experiences or qualifications, and why you are interested in the position. If considered for the position, a background check will be completed at the request of MPCGA and references will be requested.

Send to:

HR- Claims Department

PO BOX 531266

Livonia, MI 48153-1266

 

MPCGA is an equal employment opportunity organization