JOB TITLE: TORT CLAIMS SUPERVISOR

JOB CODE: 70343

SERIES NATURE OF WORK: The Tort Claims job series describes work in the investigation, evaluation, negotiation, and disposition of tort claims that are filed against commonwealth agencies or entities due to agency or employee negligence.

DEFINITION: This is professional supervisory and advanced technical work in the management of tort claims, employee liability claims, and line-of-duty death benefit claims.

An employee in this job reviews and assigns tort claims, oversees claims investigations and adjudications, investigates employee liability claims, and administers the statewide line-of-duty death benefit programs. Work involves supervising staff who conduct claim investigations and settle property and bodily injury claims against commonwealth agencies. Work includes conducting investigations for personal injury claims against commonwealth employees; assessing economic and non-economic damages; negotiating, authorizing, or denying claim payments; and preparing formal investigative reports. Work also includes developing performance measures to identify and resolve inconsistencies in claims processing; developing and implementing policies and procedures to improve program efficiency; and reviewing investigatory reports and determinations to ensure work is compliant with applicable laws and regulations. Work is performed independently and reviewed by an administrative supervisor through observation and upon completion for adherence to procedures, standards, and timelines.

   DISTINGUISHING CHARACTERISTICS:

     • Work is distinguished from the lower-level job by the responsibility for supervising Tort Claims Evaluator employees, processing personal injury claims, and evaluating claim forms to process line-of-duty death benefits.

EXAMPLES OF WORK: (NOTE: The examples of work are representative of the work, but every position classified to this job may not perform all examples of work listed. Conversely, this is not an all-inclusive list of work examples.)

• Plans, manages, and coordinates the activities of staff engaged in the evaluation and disposition of property tort claims and bodily injury tort claims.

• Determines the eligibility, legal strategy, and disposition of employee liability claims.

• Interviews claimants who suffer permanent and severe physical, emotional, and mental damage.

• Investigates claims for damages alleging negligence, employment discrimination, wrongful discharge, sexual harassment, assault, false arrest, defamation, invasion of privacy, or violation of any other civil rights.

• Rejects claims coverage for conduct determined as intentional, willful or malicious, or performed outside the scope of employment.

• Calculates compensation for emotional distress and loss of earning capacity.

• Conducts internal investigations for claims involving public interest and significant impact to the commonwealth.

• Reviews claims associated with the Emergency Responder and Law Enforcement Death Benefit for public safety officers killed in the line of duty.

• Provides guidance to subordinates investigating bodily injury claims involving unquantifiable damages such as total disability, extensive physical injuries, and fatalities.

• Develops policies and procedures for improving program efficiency.

• Develops and conducts formal and on-the-job training for lower-level staff.

• Negotiates settlement amounts with claimants, attorneys, and insurance professionals.

• Authorizes claim payments within established settlement authority and prepares reports and justifications for settlement recommendations that exceed settlement authority.

• Monitors the scope, caliber, and final adjudication of all investigations and negotiations to ensure adherence to federal and state laws, policies, and procedures.

• Prepares investigative reports; forwards files of unsettled claims to commonwealth attorneys for claimants pursuing formal litigation.

• Develops program performance measures to determine program effectiveness.

• Travels to conduct investigations and collect onsite evidence.

• Operates motor vehicles.

• Employees in this job may participate in subordinates’ work consistent with operational or organizational requirements.

• Performs the full range of supervisory duties.

• Performs related work as required.

ENTRY LEVEL KNOWLEDGES, SKILLS, AND ABILITIES:

• Knowledge of laws, regulations, and statutes related to third-party claims administration.

• Knowledge of the principles and practices of tort claims investigation, evaluation, negotiation, and disposition.

• Knowledge of methods and techniques required in negotiation and settlement of personal injury, bodily injury, civil rights, and third-party claims.

• Knowledge of the use and functionality of Microsoft Office Suite Software.

• Ability to prepare justifications based on the rules of evidence and discovery.

• Ability to operate a motor vehicle.

• Ability to communicate effectively orally.

• Ability to communicate effectively in writing.

• Ability to establish and maintain effective working relationships.

MINIMUM EXPERIENCE AND TRAINING: (NOTE: Based on the Entry Level Knowledges, Skills, and Abilities)

• One year of experience as a Tort Claims Evaluator or Insurance Claims Evaluator 2 (commonwealth titles);

or

• Two years of professional experience as a third-party claims adjuster, examiner, or investigator, and a bachelor’s degree;

or

• Four years of technical experience in evaluating or processing claims, or interviewing consumers to collect or review financial, insurance, or personal information to determine next actions, and two years of professional experience as a third-party claims adjuster, examiner, or investigator;

or

• An equivalent combination of experience and training.

SPECIAL REQUIREMENT:

• All positions require possession of an active motor vehicle license.