Job Closed
This listing is no longer active.
At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs.
Material Misrepresentation Claims Adjuster
Location
United States
Posted
66 days ago
Salary
$50K - $82.3K / year
Seniority
Senior
Job Description
Material Misrepresentation Claims Adjuster
Allstate
• Investigating claims involving potential material misrepresentation • Conducting thorough coverage and liability investigations • Analyzing policy information, statements, and supporting documentation • Drafting clear, well-supported coverage determination and denial letters • Collaborating with internal partners for consistent claim resolutions • Maintaining detailed documentation in accordance with regulatory and company guidelines
Job Requirements
- Solid background in claims handling with direct experience in coverage investigation and liability determination
- Demonstrated experience investigating policy fraud or material misrepresentation
- Ability to accurately interpret policy language and confidently communicate coverage decisions in writing
- High level of attention to detail
- Strong analytical skills and sound judgment
Benefits
- Equal Opportunity employer – Veterans/Disabled and other protected categories
- Health insurance
- 401(k)
- Paid time off
- Flexible work arrangements
- Professional development opportunities
Related Guides
Related Categories
Related Job Pages
More Claims Specialist Jobs
CA Senior Liability Claims Specialist
CorVel CorporationRaising the bar for care. Lowering risk for clients.
The Senior Liability Claims Specialist manages mid to complex Auto and/or General Liability claims, including bodily injury and property damage. This role aims to achieve optimal outcomes for both CorVel and our clients. The Senior Liability Claims Specialist handles litigated files and works with delegated authority, adhering to company best practices. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: - Receives claims, confirms policy coverage and acknowledgment of the claim - Determines validity and compensability of the claim - Investigates claims and handles Auto and/or General Liability claims - Establishes reserves and authorizes payments within reserving authority limits - Communicates claim status with the customer, claimant, and client - Adheres to client and carrier guidelines and participates in claims review as needed - Collaborates with team members on more complex or problematic claims as necessary - Additional duties as assigned KNOWLEDGE & SKILLS: - Excellent written and verbal communication skills - Ability to learn rapidly to develop knowledge and understanding of claims practice - Ability to identify, analyze and solve problems - Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets - Strong interpersonal, time management, and organizational skills - Ability to meet or exceed performance expectations - Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: - Five (5) or more years’ experience handling General Liability claims, including high exposure and/or litigated claims - Two (2) or more years' experience handling Auto Liability claims - Bachelor's degree or a combination of education and related experience - Current Adjuster’s License in state of operation is required - Multi-State license is preferred - Municipality experience is a plus PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $29.35 - $47.28 per hour A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL: CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote
Property Claims Specialist
Mercury InsuranceTrusted by customers. Loved by team members. The smarter way to career.
• Investigate and resolve Homeowners claims of minor to moderate complexity in a timely and efficient manner. • Investigates Homeowner personal property losses by obtaining relevant loss information from insureds, vendors, witnesses, and other interested parties through the use of statements, policy reports, etc. • Ability to use imagery and advanced video technology to collaborate with onsite vendors and insureds to identify damage and write damage estimates from a virtual setting. • Compare facts gathered during the investigation against the policy to determine coverage of claim; extend or deny coverage as appropriate. • Establishes reserve amounts within prescribed settlement authority limit and negotiates settlement of claims; recommends claims which exceed personal authority limit to supervisor for approval. • Responsible for effectively and timely communicating with insureds and/or their representatives to resolve issues and ensure customer satisfaction. • This includes timely response to phone calls, emails, texts, written communication, and adherence to Department of Insurance requirements. • Prioritizes own responsibilities and effectively manages claims workload to regularly monitor progress and expenses to properly resolve inventory to conclusion. • At times may direct, monitor, and review files handled by independent adjusters to conclusion.
Claims Adjuster - Liability, GL and Litigation
SedgwickSedgwick Germany GmbH, basée à Düsseldorf, fait partie du groupe Sedgwick, un acteur de référence au niveau international dans les domaines de la gestion de sinistres, de l’expertise et de l’analyse des risques. En Allemagne, nous allions la solidité d’un grand groupe à l’agilité d’une structure à taille humaine. Nos clients, principalement issus du secteur de l’assurance, s’appuient sur notre savoir-faire reconnu en gestion de sinistres, fidèle à notre engagement : « we care ».
• To analyze mid- and higher-level general liability claims to determine benefits due. • To ensure ongoing adjudication of claims within company standards and industry best practices. • To identify subrogation of claims and negotiate settlements. • Manages mid-level general liability claims by gathering information to determine liability exposure. • Assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level. • Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract. • Manages subrogation of claims and negotiates settlements. • Communicates claim action with claimant and client. • Ensures claim files are properly documented and claims coding is correct.
Senior Workers Compensation Claims Adjuster - California
GallagherInclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on protected characteristics by applicable federal, state, or local laws.
Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose. Overview - Jurisdictions: California - Licenses: An active CA Designation is required (up to date on CE hours). SIP optional. - Location: This role is eligible for fully remote work. How you'll make an impact - Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims. - Interact extensively with various parties involved in the claim process to ensure effective communication and resolution. - Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process. - Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements. - Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file. About You • Claims Background: Minimum of 3-5 years of hands on workers compensation adjusting experience including handling a lost time/indemnity desk plus litigation. • Jurisdictional Experience: California Workers Compensation • Active Adjusters' licenses: CA Designation required. SIP optional. As a key member of our experienced Claims Adjuster team, you will: • Investigate, evaluate, and resolve complex workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution. • Work in partnership with our clients to deliver innovative solutions and enhance the claims management process • Think critically, solve problems, plan, and prioritize tasks to optimally serve clients and claimants REQUIRED QUALIFICATIONS: • High School Diploma. • Minimum of 5 years related claims experience. • Appropriately licensed and/or certified in all states in which claims are being handled. • Knowledge of accepted industry standards and practices. • Computer experience with related claims and business software. DESIRED: • Bachelor's Degree #LI-HS1 Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve: - Medical/dental/vision plans, which start from day one! - Life and accident insurance - 401(K) and Roth options - Tax-advantaged accounts (HSA, FSA) - Educational expense reimbursement - Paid parental leave Other benefits include: - Digital mental health services (Talkspace) - Flexible work hours (availability varies by office and job function) - Training programs - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing - Charitable matching gift program - And more... **The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.




