Class Code: 00452

IOWA DEPARTMENT OF ADMINISTRATIVE SERVICES –

HUMAN RESOURCES ENTERPRISE

INSURANCE CLAIMS INVESTIGATOR

DEFINITION

Under general supervision, assists in the development and administration of a claims and insurance program; performs related work as required.

The Work Examples and Competencies listed are for illustrative purposes only and not intended to be the primary basis for position classification decisions.

WORK EXAMPLES

Investigates agency related tort claims to assemble pertinent information and prepare an investigation report by reviewing written reports, contracts, public records, other documents and interviewing complainants, complaint respondents, witnesses, lawyers, and others as necessary.

Cooperates with the Attorney General's Office to facilitate the investigation and hearing by assisting in the hearing preparation, making hearing and court appearance, and exchanging pertinent information.

Assists in the development, maintenance, and implementation of accident reporting or complaint handling procedures in order to guide departmental regulation, enforcement and investigative activities.

Conducts extensive field investigations of vehicle accidents involving agency vehicles and other accidents related to tort claims or highway property damage; interviews drivers, witnesses, investigating officers, tow truck operators and others; analyzes accidents to determine cause and responsible party; checks road condition; condition of vehicles involved.

Confers and/or corresponds with company representatives, attorneys, employees, and/or the general public in order to alleviate or solve insurance related problems by contact in person, over the telephone or by mail.

Conducts training sessions of field personnel on claim and accident investigation and the recognition of accidents or incidents that require professional investigation.

COMPETENCIES REQUIRED

Knowledge of the investigative techniques necessary for the comprehensive determination of facts in disputed issues.

Knowledge of accident investigation procedures, practices, and analysis.

Knowledge of the policies, procedures, practices and laws applicable to the situation under investigation.

Knowledge of the legal provisions concerning the collection and admission of evidence in court.

Knowledge of interviewing techniques.

Ability to adapt investigative methods and techniques to specific situations.

Ability to observe and record facts clearly and accurately.

Displays high standards of ethical conduct. Exhibits honesty and integrity. Refrains from theft-related, dishonest or unethical behavior.

Works and communicates with internal and external clients and customers to meet their needs in a polite, courteous, and cooperative manner. Committed to quality service.

Displays a high level of initiative, effort and commitment towards completing assignments efficiently. Works with minimal supervision. Demonstrates responsible behavior and attention to detail.

Responds appropriately to supervision. Makes an effort to follow policy and cooperate with supervisors.

Aligns behavior with the needs, priorities and goals of the organization.

Encourages and facilitates cooperation, pride, trust, and group identity. Fosters commitment and team spirit.

Expresses information to individuals or groups effectively, taking into account the audience and nature of the information. Listens to others and responds appropriately.

EDUCATION, EXPERIENCE, AND SPECIAL REQUIREMENTS

Successful completion of four years (120 semester hours or the equivalent) of coursework in an accredited college or university and two years of work experience in accident or other investigative work (i.e. to determine the cause or responsibility in illegal or inappropriate actions involving the public domain);

OR

an equivalent combination of education and experience substituting one year of the required experience for one year (thirty semester or equivalent hours) of the required education with a maximum substitution of four years.

SPECIAL NOTE:

Incumbents in these positions may be required to travel and stay out overnight. Incumbents will be required to make arrangements on their own regarding transportation to and from assigned work areas. Some out of state travel may be required as assigned by the agency of employment.

Effective Date: 8/30/85 BW