CONSUMER INSURANCE INVESTIGATOR 1 - 05122026-77365

Job Information

LOCATION OF (1) POSITION(S) TO BE FILLED: DEPARTMENT OF COMMERCE & INSURANCE, DAVIDSON COUNTY

Regular in the Consumer Information Services

Qualifications

Overview

Under general supervision, is responsible for insurance investigation duties of average difficulty; and performs related work as required. This is the working-level class in the Consumer Insurance Investigator sub-series. An employee in this class may be assigned to a central office or to a district office. An incumbent performs a wide variety of sensitive and complex assignments in investigating complaints and enforcing state laws, primarily for a specific line of insurance. Work involves conducting interviews with company representatives, complainants, policyholders, agents, brokers, and the general public to gather information, resolve complaints and disputes, and terminate illegal or unethical practices. Work is performed with considerable independence and is reviewed by an administrative superior for effectiveness and sound judgment. This class differs from Consumer Insurance Investigator 2 in that an incumbent of the latter is responsible for the operation of a district office and investigates complaints in all lines of insurance.

Responsibilities

1. Mediates complaints between the consumer and the insurance company based on information provided through documents and phone interviews with the goal of achieving a mutually acceptable solution.
2. Conduct investigations to resolve difficult and sensitive disputes involving company representatives, complainants, policyholders, agents and brokers. Respond in a timely manner to all insurance-related inquiries from the general public.
3. Evaluate responses in relation to state insurance laws, policy language, rules as well as state and federal regulations.
4. Keep knowledge up to date related to changes in laws and regulations. Attend training sessions related to system changes in database and other systems utilized.
5. Conduct investigations of complaints from policyholders related to insurance violations, unfair trade practices or fraudulent activities by insurance agents or insurance companies, primarily for one line of insurance.
6. Generates concise notes related to the complaint file in the complaint database.
7. Attains information from complaint form in order to review and interpret information and contact the complainant and respondent.
8. Verifies complainant and company information for each complaint resulting in acknowledgement and respondent letters. Enters NAIC reason, coverage and disposition codes into the complaint file in the complaint database.

Competencies (KSA's)

Competencies:
1. Customer Focus
2. Directs Work
3. Communicates Effectively
4. Instills Trust
5. Decision Quality

Knowledges:
1. Customer and Personal Service
2. Law and Government
3. English Language

Skills:
1. Active Learning and Listening
2. Time Management
3. Judgment and Decision Making
4. Negotiation
5. Persuasion

Abilities:
1. Deductive Reasoning
2. Inductive Reasoning
3. Written Comprehension
4. Speech Recognition

Tools & Equipment

1. Basic Office Equipment

TN Driver Standards

State of Tennessee positions that may involve driving responsibilities require candidates to meet the following minimum driver qualifications:

• A valid driver's license
• For the past five years, the candidate's driver record must not have record of the following violations: driving under the influence (DUI), reckless driving, license suspension for moving violations, more than 4 moving violations.

Please include your Driver's License Information under the Licenses and Certifications section of your application.

**Agencies may allow an exception based on other factors.