Workers' Compensation Claims Adjuster

Company: AmTrust North America ( Learn More )

General Information
4 Year Degree
2 to 5 years
Not Specified
Job Description Overview

The workers compensation claims adjuster is responsible for the prompt and efficient examination, investigation and settlement or declination of workers compensation insurance claims through effective research, negotiation and interaction with insures and claimants, ensuring that company resources are utilized in a cost effective manner in the process. Specifically, this position will handle workers comp claims for multiple states.


Duties include but are not limited to:

  • Review, process and conclude high exposure liability claims or those limited in exposure but occasionally complex in nature
  • Oversee and direct a majority of litigated or potentially litigated claims, directing and controlling the work and expenses of investigative services or attorneys
  • Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud and resolution potential
  • Conduct a thorough analysis of liability and damages; continually assess exposure and evaluate for accurate reserves
  • Complete quality investigations by gathering all pertinent information (recorded statements, review of police and medical reports, photographs and appraisals/estimates of damages, etc.)
  • Determines if subrogation exists and takes steps necessary to initiate recovery efforts
  • Maintains appropriate financial accountabilities (reserving) and controls loss adjustment expenses
  • Fulfill state licensing agreements/requirements (if applicable) and apply knowledge of state laws and regulations pertaining to the insurance industry
  • Job Requirements
    • Bachelor’s degree preferred
    • 2 to 5 years experience in handling workers comp claims
    • Maintain valid adjusters’ license(s) in states assigned or an ability to obtain same
    • 2 years experience in job-related functions or equivalent
    • Insurance coursework (e.g. IIA, CPCU, SCLA and AEI) is beneficial
    • Good knowledge of insurance theory and practices; insurance contracts and their application
    • Must have Massachusetts Workers Compensation claims handling experience