Date Opened: Nov 17, 2021
Location: Remote, Remote, US
Company: Allstate Insurance Company
The Adjusting Function is responsible for verifying policy coverage and limits. The Adjusting function investigates and evaluates damage and/or liability; estimates damages, losses, or total indemnity; sets and maintains reserves; and/or negotiates and settles claims. Special Investigative Unit (SIU) work is performed by a specialized unit that proactively utilizes analytical tools to handle the most complex or specialized claims possibly in litigation and works with specialized counsel and law enforcement to detect, investigate, prosecute and deter fraud.
Under limited supervision, this job is responsible for investigating and analyzing complex, multi-discipline coverage and claims that have been referred to the special investigation unit (SIU) for potential fraud. This role typically handles a combination of complex attorney represented and unrepresented claims and moderate to complex losses, in which suspicious activity has been identified. The individual performs a thorough investigation including; (1) conducting background searches, scene investigations, and clinic inspections; (2) taking recorded statements; (3) reviewing and analyzing medical notes, bills, and property damage; and (4) conducting witness interviews and social media searches. The individual conducts surveillance on property and/or creates scene reconstructions on some investigations and reviews whether fraud can be substantiated and supports a lawsuit. The individual provides work guidance and direction to less senior employees and provides mentoring and coaching to the team. The individual also delivers compassionate service that is fast, fair, and easy, to ensure customer retention. The individual works independently, prioritizing the individual's own responsibilities, and managing the individual's own workload. The individual also consistently meets band level behaviors, production, quality, and/or customer service goals.