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Fred Loya Insurance

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Claims Adjuster- ATR

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Position Summary

The ATR Adjuster investigates, evaluates, negotiates, and resolves assigned casualty claims in accordance with policy provisions, applicable laws and regulations, and Company claims-handling standards. This role manages attorney-represented and unrepresented claims, provides timely and professional service to all parties, maintains accurate reserves and documentation, and works toward fair, efficient, and well-supported claim resolutions.

Essential Duties and Responsibilities

  • Review and interpret insurance policies, endorsements, and related contract documents to confirm applicable coverage.

  • Investigate claims and determine liability by analyzing reports and supporting documents, conducting telephone interviews, and evaluating negligence and damages.

  • Manage attorney-represented bodily injury claims and as assigned, claims involving unrepresented parties.

  • Evaluate claim exposure and negotiate fair, reasonable, and well-supported settlements with attorneys, claimants, and other authorized parties.

  • Handle Medical Payments and Personal Injury Protection claims in accordance with policy provisions and applicable requirements.

  • Establish and maintain appropriate reserves based on current claim exposure and update reserves as new information becomes available.

  • Maintain a timely, accurate, and complete claim file by documenting contacts, evaluations, decisions, negotiations, and other activities.

  • Communicate coverage, liability, claim status, and settlement decisions clearly and professionally.

  • Deliver courteous, responsive, and solution-focused service throughout the claims process.

  • Manage an assigned pending inventory, prioritize competing deadlines, and complete required follow-up within established service standards.

  • Comply with all Company casualty claims practices, procedures, authority levels, confidentiality requirements, and applicable laws and regulations.

  • Maintain all required adjuster licenses, continuing education requirements, and remain in good standing in each assigned jurisdiction.

  • Perform other duties and special assignments as directed by management.

Qualifications and Requirements

  • Ability to read, interpret, and apply insurance policies, contracts, statutes, regulations, and claims procedures.

  • Strong analytical, investigative, decision-making, negotiation, and problem-solving skills.

  • Excellent written and verbal communication skills, including the ability to discuss coverage, liability, damages, and bodily injury settlements with attorneys and other parties.

  • Ability to work in a fast-paced environment, adapt to changing priorities, manage current pending inventory, and meet deadlines with limited supervision.

  • Sound judgment, professionalism, discretion, and attention to detail when handling sensitive and confidential information.

  • Proficiency with Microsoft Office applications, including Word, Excel, Outlook, and PowerPoint; ability to learn Company claims systems.

  • Ability to obtain and maintain a Texas All-Lines Adjuster license and any additional licenses required for assigned jurisdictions.

  • Maintain continuing education requirements to maintain adjuster licenses up to date.

Education and Experience

  • Bachelor's degree from an accredited college or university or 2+ years casualty adjusting experience.

  • Claims handling, insurance, legal, negotiation, or customer service experience preferred.

  • Experience handling bodily injury or attorney-represented claims preferred.

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