Legal Assistant - Workers Compensation JobotLegal Assistant - Workers CompensationTroy, MI$50,000–$65,000 / yearInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. e are seeking an experienced Workers’ Compensation Legal Assistant to support attorneys handling employer and insurer-side workers’ compensation matters from initial intake through hearing and appeal.
Claims Consultant Tata Consultancy Services LtdClaims ConsultantPlymouth, MI$48,000–$55,000 / yearResponsibilities: To provide Absence case management and claim adjudications, based on medical documentation and the applicable Disability/FMLA/Paid Family Leave interpretation, including determining benefits due and making timely payments and adjustments. Determines benefits due, makes timely claims payments/approvals and adjustments for Workers Compensation, State Short Term Disability, and other disability offsets.
Complex Claims Consultant - Private & NFP D&O CNA Financial CorpComplex Claims Consultant - Private & NFP D&OMI$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex Financial Lines claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
Property & Casualty Insurance Claims Operations Consultant, Manager PricewaterhouseCoopers LLPProperty & Casualty Insurance Claims Operations Consultant, ManagerMI$99,000–$232,000 / yearPwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy . You will analyze client needs, implement solutions, and provide training and support to validate seamless integration and utilization of business applications, enabling clients to achieve their strategic objectives.
NewClaims Consultant, Life Sciences CNA Financial CorpClaims Consultant, Life SciencesSouthfield, MI$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex commercial claims with large exposures that require a high degree of technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to complex manage litigation and authorizing payments within scope of authority.
Technical Consultant Casualty Claims- CGL The Hanover Insurance Group IncTechnical Consultant Casualty Claims- CGLMIRemotePOSITION OVERVIEW: Make an Impact with our Complex Casualty Claims team where claims is more than managing losses, its about solving complex problems, delivering confidence in uncertain situations, and protecting what matters most to our customers. Interpret indemnity and hold harmless agreements, evaluate additional insured coverage, identify priority of coverage issues, and strategically leverage risk transfer strategies to mitigate exposure in multi-party, litigated CGL claims.
NewConsultant Casualty Claims The Hanover Insurance Group IncConsultant Casualty ClaimsHowell, MIDigital Fluency: Effectively uses digital tools and technology appropriately to find, evaluate, create, and communicate information understands how to navigate digital platforms, use software applications, and leverage technology for productivity and communication purposes. Customer Centricity: Makes customers/clients and their needs a primary focus of one's actions; shows interest in and understanding of the needs and expectations of internal and external customers; gains customer trust and respect; meets or exceeds customer expectations.
Technical Consultant Casualty Claims The Hanover Insurance Group IncTechnical Consultant Casualty ClaimsHowell, MIDigital Fluency: Effectively uses digital tools and technology appropriately to find, evaluate, create, and communicate information understands how to navigate digital platforms, use software applications, and leverage technology for productivity and communication purposes. Customer Centricity: Makes customers/clients and their needs a primary focus of one's actions; shows interest in and understanding of the needs and expectations of internal and external customers; gains customer trust and respect; meets or exceeds customer expectations.
Regional Director, Executive Liability Claims - Claims Marsh & McLennan Companies IncRegional Director, Executive Liability Claims - ClaimsTroy, MI$82,400–$153,500 / yearWith offices across North America, we combine the personalized service model of a local consultant with the global resources of the world's leading professional services firm, Marsh (NYSE: MRSH). Marsh McLennan Agency (MMA) provides business insurance, employee health & benefits, retirement, and private client insurance solutions to organizations and individuals seeking limitless possibilities.
NewCommunication Effectiveness Trainer - Allstate Claims University Allstate Insurance CompanyCommunication Effectiveness Trainer - Allstate Claims UniversityMI$62,100–$105,300 / yearCoaching, Coaching, Coaching Techniques, Collaboration, Collaborative Development, Communication, Communication Strategy Development, Cultural Awareness, Design, Development Communication, Empathic Communication, Facilitating Learning, Facilitation, Indian Culture, Instructional Design, Leadership, Learning and Development (L&D), Learning Effectiveness, Learning Materials Development, Negotiation, Objection Handling, Performance Management (PM), Project Coordination, Project Planning, Results-Oriented {+ 7 more}. Develops, designs and delivers learning offerings that are aligned to business and enterprise strategy; Ensures talent management practices are understood and supported consistently within learning offerings; Drive adoption of skills-based culture to empower and develop meaningful business-relevant skills through design and delivery of learning.
TEMP-Senior Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP-Senior Workers' Compensation Claims AdjusterMI$48.65–$57.59 / hourBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C. Essential Responsibilities: Working under limited technical direction and within broad limits and authority, adjudicate highly complex indemnity workers' compensation claims on assignments reflecting potentially with significant impact on departmental results.
TEMP- Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP- Workers' Compensation Claims AdjusterMI$37.66–$44.33 / hourBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C. Essential Responsibilities: Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical complexity, with a direct impact on departmental results.
TEMP-Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP-Workers' Compensation Claims AdjusterMI$37.66–$44.33 / hourBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C. Rockwood has become a leading underwriter of workers' compensation for the mining industry by offering workers' compensation insurance with a commitment to providing the best service on loss control and claims, collaborating across all departments with this common goal.
TEMP-Workers'''' Compensation Claims Adjuster Argo Group International Holdings IncTEMP-Workers'''' Compensation Claims AdjusterMI$37.66–$44.33 / hourBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C. Essential Responsibilities: Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical complexity, with a direct impact on departmental results.
Medical Only Claims Spec I/II Emergent Holdings IncMedical Only Claims Spec I/IILansing, MIAssociate's degree in insurance, business administration, health administration and/or related field with progress towards or completion of Insurance Institute of America (IIA) or other insurance related designation(s) and two (2) years of insurance experience including one (1) year experience in a property & casualty claims role (i.e. applying regulations, guidelines, and/or policies that would impact claims and/or underwriting outcomes in a property & casualty environment). ADDITIONAL SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED FOR MOCS II: Demonstrated ability to use diplomacy, discretion, and appropriate judgment when responding to inquiries from staff and external customers as well as anticipating needs of the department.
Senior Director, Insurance Claims Advisory NTT DATA Group CorpSenior Director, Insurance Claims AdvisoryMI$160,000–$296,000 / yearEcosystem & Partnership Leadership: Develop joint GTM motions with key alliance partners and Independent Software Vendors (ISVs) in the insurance space (e.g., Guidewire, Duck Creek, Majesco, Verisk). to amplify market reach and deliver integrated client solutions. A critical component of this role is serving as the primary pre-sales Claims domain expert for the North American P&C and L&A sales team, translating complex IT capabilities into tangible business outcomes (e.g., improved claims efficiency, lower loss ratio).
Adjuster, Property Insurance Claims Elevate Claims SolutionsAdjuster, Property Insurance ClaimsGrand Rapids, MichiganElevate Claims Solutions is founded on the belief that human experience and claim quality are the essence of profitable growth and retention for our adjuster partners, our clients, and ourselves. Valuing our partnerships with our carrier clients; recognizing and maximizing the ways in which our Elevated Claims Handling can support them and their policyholders.
Property Adjuster Insurance Claims Elevate Claims SolutionsProperty Adjuster Insurance ClaimsSaginaw, MichiganElevate Claims Solutions is founded on the belief that human experience and claim quality are the essence of profitable growth and retention for our adjuster partners, our clients, and ourselves. Valuing our partnerships with our carrier clients; recognizing and maximizing the ways in which our Elevated Claims Handling can support them and their policyholders.
Claims Representative - Auto SET SEGClaims Representative - AutoEast Lansing, MIFull timeSET SEG is looking for an Auto Claims Representative that will be responsible for the end-to-end handling of assigned auto physical damage claims, with additional exposure to small property damage claims based on business needs. SET, which began in 1971, served as an employee benefits association focused on offering comprehensive and affordable employee benefit solutions to Michigan public schools and their employees.
NewSenior Workers'''' Compensation Claims Adjuster (Hybrid) Amerisure Mutual Insurance CompanySenior Workers'''' Compensation Claims Adjuster (Hybrid)Farmington Hills, MIRanked as one of the top 100 Property & Casualty companies in the United States, we proudly manage nearly $1 Billion of Direct Written Premium and maintain $1.21 billion in surplus. Amerisure is currently recruiting for a Hybrid Senior Workers' Compensation Claims Adjuster working onsite 3 days a week on in one of our offices.
Senior Workers'''' Compensation Claims Adjuster (REMOTE) Amerisure Mutual Insurance CompanySenior Workers'''' Compensation Claims Adjuster (REMOTE)Farmington Hills, MIRemoteRanked as one of the top 100 Property & Casualty companies in the United States, we proudly manage nearly $1 Billion of Direct Written Premium and maintain $1.21 billion in surplus. As a property and casualty insurance company, Amerisure's promise to our partner agencies and policyholders begins with a comprehensive line of insurance products designed to protect businesses, as well as the health and safety of every employee.
Senior Workers' Compensation Claims Adjuster (Hybrid) Amerisure Mutual InsuranceSenior Workers' Compensation Claims Adjuster (Hybrid)Farmington Hills, MichiganRanked as one of the top 100 Property & Casualty companies in the United States, we proudly manage nearly $1 Billion of Direct Written Premium and maintain $1.21 billion in surplus. Amerisure is currently recruiting for a Hybrid Senior Workers’ Compensation Claims Adjuster working onsite 3 days a week on in one of our offices.
Medical Only Claims Trainee Emergent Holdings IncMedical Only Claims TraineeLansing, MIADDITIONAL EDUCATION, EXPERIENCE, SKILLS, KNOWLEDGE AND/OR ABILITIES PREFERRED: (Briefly detail the preferred education, experience, skills, knowledge and/or abilities desired to perform this job, including certifications). Reads, routes and keys incoming mail, runs reports and answers/responds to incoming phone calls on both direct and ACD line, faxes and emails.
Experienced PIP Claims Representative Auto-Owners Insurance GroupExperienced PIP Claims RepresentativeMIReview medical bills, authorize payments and ensure payments are issued in a timely and accurate manner in accordance with the Michigan No Fault Statute. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs.
TEMP- Claims Adjuster Argo Group International Holdings IncTEMP- Claims AdjusterMI$37.66–$44.33 / hourCalifornia outside of Los Angeles, San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, Washington State, and New York State (including Westchester County) Pay Ranges: $41.44 - $48.79 per hour. Essential Responsibilities: Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical complexity, with a direct impact on departmental results.
Field Claims Representative - Manistee, Grand Traverse, and Leelanau Counties Auto-Owners Insurance GroupField Claims Representative - Manistee, Grand Traverse, and Leelanau CountiesTraverse City, MIAbility to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents). This job requires mastery of claims-handling skills and requires the person to: Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability.
Field Claims Representative - Emmet County Auto-Owners Insurance GroupField Claims Representative - Emmet CountyMIAbility to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents). This job requires mastery of claims-handling skills and requires the person to: Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability.
Claims Representative - Multi-Line SET SEGClaims Representative - Multi-LineEast Lansing, MIFull timeThe Multi-Line Property and Casualty Claims Representative is responsible for the prompt, fair, and efficient handling of a diverse caseload of Property and Casualty claims across multiple lines including general liability, auto liability, auto physical damage, personal injury protection (PIP), property, medical payments and select specialty coverages. This position requires independent judgment, strong documentation practices, and a customer-focused approach with the ability to balance efficiency with accuracy and compliance with applicable laws, regulations, and internal claims handling guidelines.
Orthodontic Claims Resolution Representative Great Expressions Dental CentersOrthodontic Claims Resolution RepresentativeSouthfield, MIOur recently appointed leadership team brings over a century of collective dental expertise and is backed by dynamic investment support to pave the way for groundbreaking changes. The Orthodontic Claims Resolution Representatives' primary role is to resolve high volumes of aging orthodontic insurance claims with payers and providers by calling insurance companies or by utilizing their websites when available.
CLAIMS AND INSURANCE SPECIALIST Covenant HealthCareCLAIMS AND INSURANCE SPECIALISTSAGINAW, MichiganFull timeResponsibilities: Responsible for maintaining the hospital’s insurance coverages making certain appropriate coverage is in place, monitoring insurance premiums, completing applications and yearly renewals, working with various departments within the organization to gather the information necessary so that the hospital is fully insured. This individual provides the institution with policies, procedures and guidelines to protect the institution against loss, including those intended to reduce losses associated with patient, employee, or visitor injuries; proper loss or damage; hospital policies and other sources of organizational liability or may result in the filing of lawsuits.
Multi-Line Claims Adjuster - Michigan Provencher & Company, LLCMulti-Line Claims Adjuster - MichiganLansing, MIWe excel in providing professional, knowledgeable claims professionals to handle large losses, catastrophe claims, business interruption and daily property claims, as well as handle complete liability investigations, task assignments including scene investigations and property damage appraisals, construction defect claims as well as first party automobile claims for personal and commercial insurance policyholders. Experience in industry specific areas a plus, but not necessary: fire departments, agricultural, lumber mills, high value or historic buildings or Construction Defects, Automobile Liability, Subrogation Recovery investigations.
Senior Claims Examiner - Home Office Motor Carrier and Auto Liability Auto-Owners Insurance GroupSenior Claims Examiner - Home Office Motor Carrier and Auto LiabilityLansing, MIOur group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success.
Claims Expediter Auto-Owners Insurance GroupClaims ExpediterLansing, MIAcquiring knowledge of basic, limited, claim handling procedures; and have the ability to recognize when exceptional circumstances require involvement of the Branch Manager, Claim Supervisor, or a Branch, Field, or Senior Claim Representative. The position requires the person to: Contact involved parties, describe claim process, initiate completion of claim documentation, confirm the amount of loss, and pay the claim as dictated by Company guidelines.
NewClaims First Notice of Loss (FNOL) Representative II - General Motors Insurance General Motors Financial Company, Inc.Claims First Notice of Loss (FNOL) Representative II - General Motors InsuranceDetroit, MIRemote$34,000–$84,000 / yearGM Financial is the wholly owned captive finance subsidiary of General Motors and is headquartered in Fort Worth, U.S. We are a global provider of auto finance solutions, with operations in North America, South America, and the Asia Pacific region. The position delivers exceptional customer service while coordinating claim initiation activities, supporting customers'' needs, and contributing to operational goals during both regular and catastrophe-related claim events.
Pharmacy Claims Adjudication Specialist Onco360Pharmacy Claims Adjudication SpecialistSaint LouisSkills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360.
Loss Claims Specialist Fifth Third BancorpLoss Claims SpecialistGrand Rapids, MIGENERAL FUNCTION: Under moderate supervision, collects and documents accounts involved in total or repairable loss claims involving a primary insurance carrier and/or GAP company in accordance with departmental, investor, and legal guidelines. The base salary for this position is reflective of the range of salary levels for all roles within this pay grade across the U.S. Individual salaries within this range will vary based on factors such as role, relevant skillset, relevant experience, education and geographic location.
Healthcare Claims Quality Analyst Integra PartnersHealthcare Claims Quality AnalystTroy, MIRemoteFull timeThe Claims Quality Assurance Analyst is responsible for monitoring and documenting production quality in support of departmental goals and initiatives, with a primary focus on claims auditing and claims-related interactions within the Revenue Cycle Management (RCM) function. Working knowledge of Revenue Cycle Management (RCM) workflows and downstream impacts (e.g., clean claim submission, edits, denials, appeals, payment posting/reconciliation) across commercial, Medicaid, and Medicare.
Commercial Claims Advocate Kapnick & Company, IncCommercial Claims AdvocateAdrian, MIOur 180+ colleagues provide expert guidance and creative problem solving pertaining to business insurance, risk solutions, employee benefits, worksite well-being, and personal insurance to a vast and diverse base of clients worldwide. For over 75 years, companies and individuals have looked to Kapnick as a trusted advisor, providing solutions that protect their operations and employees.
NewClaims Adjuster Trainee Allstate Insurance CompanyClaims Adjuster TraineeMI$50,000–$74,350 / yearIn this role, you'll be responsible for investigating and verifying the details of automobile accidents, including obtaining police reports, collecting witness statements, confirming coverage, and determining liability. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.
Claims Representative, Auto Sedgwick Claims Management Services, Inc.Claims Representative, AutoMI$50,000–$55,000 / yearProcesses auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Claims Representative , Auto Sedgwick Claims Management Services, Inc.Claims Representative , AutoMI$50,000–$55,000 / yearProcesses auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Auto Claims Representative (Northern Michigan) Auto-Owners Insurance CompanyAuto Claims Representative (Northern Michigan)Traverse City, MichiganAbility to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents). This job includes training and development completion of the Company’s claims training program for the assigned line of insurance and requires the person to: Investigate, evaluate, and settle entry-level insurance claims.
Auto Claims Representative Auto-Owners Insurance CompanyAuto Claims RepresentativeSaginaw, MichiganAbility to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents). This job includes training and development completion of the Company’s claims training program for the assigned line of insurance and requires the person to: Investigate, evaluate, and settle entry-level insurance claims.
Medical Claims Representative Michigan Farm Bureau Family of CompaniesMedical Claims RepresentativeLansing, MichiganFull timeWork with computer systems keying functions, including but not limited to letter composition, log entry, diary entry, report of investigation composition, and draft production. Note: If a candidate is not selected, an Associate Medical Claims Representative position may be considered on the level of experience and qualifications.
Experienced PIP Claims Representative Auto-Owners Insurance CompanyExperienced PIP Claims RepresentativeLansing, MichiganReview medical bills, authorize payments and ensure payments are issued in a timely and accurate manner in accordance with the Michigan No Fault Statute. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs.
Field Claims Representative – Emmet County Auto-Owners Insurance CompanyField Claims Representative – Emmet CountyGaylord, MichiganAbility to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents). This job requires mastery of claims-handling skills and requires the person to: Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability.
Field Claims Representative Auto-Owners Insurance CompanyField Claims RepresentativeSaginaw, MichiganAbility to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents). This job requires mastery of claims-handling skills and requires the person to: Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability.
NewBodily Injury Claims Specialist Auto-Owners Insurance CompanyBodily Injury Claims SpecialistMount Pleasant, MichiganThe position requires the person to: Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs.
Field Claims Representative – Manistee, Grand Traverse, and Leelanau Counties Auto-Owners Insurance CompanyField Claims Representative – Manistee, Grand Traverse, and Leelanau CountiesTraverse City, MichiganAbility to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents). This job requires mastery of claims-handling skills and requires the person to: Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability.
Experienced Catastrophe Claims Representative Auto-Owners Insurance CompanyExperienced Catastrophe Claims RepresentativeLansing, MichiganThe position requires the following, but is not limited to: Frequent travel up to 21 days at a time and is required upon short notice to location of catastrophe, which would most likely be out of state. Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability and pay or deny losses.