Claims Representative I

Legal & General America is a recognized market leader of term life insurance, dedicated to transforming their business through innovation and technology. The Claims Representative I is responsible for processing non-contestable claims and live rescissions, ensuring compliance with productivity and quality standards, and managing all claims-related tasks as directed by management.

Responsibilities

• Review and process live rescissions within established productivity and quality standards
• Prepare written communication to insureds regarding rescission of in force life insurance policies
• Set up, research, review and process non-contestable claims within established productivity and quality standards
• Review company records to confirm insurance coverage
• Review all beneficiary and title changes and collateral assignments for correctness and generate appropriate correspondence in accordance with state insurance regulations requesting appropriate claim requirements
• Open claims files according to departmental procedure
• Notify reinsurers of newly filed death claims
• Evaluate documentation submitted for processing of claim and confirm eligibility for payment utilizing knowledge of estates, trusts, minor beneficiary requirements, divorce statutes and other regulatory requirements. If documentation is insufficient, request correct or additional requirements needed in order to give the claim further consideration
• Correspond and communicate with claimants, attorneys, agents, reinsurers and other company departmental staff to discuss and/or resolve matters relevant to effective claims administration, including competing claim issues
• Review progress and status of pending claims with management and discuss problems and suggested solutions
• Follow up on all pending non-contestable claims within established regulatory requirements
• Follow established escheat procedures on pending claims review and run public records database searches as needed
• Process claim on administrative systems using the appropriate Post Mortem Interest statutes, dividend calculations, and contract provisions to reflect settlement or payment of claim to the appropriate party
• Send disbursement correspondence and document file reflecting interest and payment amount
• Document all activity to support claim file
• Answer phones and respond to correspondence pertaining to the initial notification of death
• Keep abreast of “red flags” for fraud and identify potential issues to prevent payment of fraudulent claims including foreign death requirements
• Complete form 712’s as needed
• As required, bill reinsurer for their share of the liability and update appropriate system. Communicate with reinsurers as needed on problem cases
• Keep abreast of claims related regulatory requirements
• Operate in a team environment and support other team members to enhance overall productivity
• Complete all other projects and tasks assigned by management

Skills

• High School diploma or equivalent
• Typing 35 WPM
• Proficiency in spreadsheet and word processing software
• Detail oriented
• Strong organization skills
• Outstanding verbal and written communication skills
• Superior customer service skills
• Good problem solving and negotiation skills
• Product knowledge and ability to understand basic contract language
• Good analytical skills
• Ability to work in a fast-paced environment
• Knowledge of Microsoft Office (Word and Excel)
• Some college preferred
• 1-2 years of experience in life or health claims or customer service/administrative position preferred

Benefits

• Sign-on bonus
• Long term incentives
• Annual bonuses
• Legal & General America Annual Incentive Plan
• 10 vacation days
• 10 sick days
• 9 paid holidays
• Health, life, and dental insurance
• 401K with company match up to 6%
• Pension package
• Generous time off
• Wellbeing initiatives

Company Overview