Claims Examiner-Construction Defect
Analyzes coverage and settles moderately complex claims in one or more of Client's specialty claims areas. Essential Duties & Responsibilities:
- Able to manage the full-life cycle of all assigned claims files.
- Analyzes coverage and determines defense obligations.
- Independently conducts thorough analysis and investigations necessary to determine claims exposure, recommend appropriate settlement strategies, and action plans.
- Creates reservation of rights and coverage denial letters.
- Negotiates settlements with clients, client attorneys, and Public Adjusters.
- Interacts extensively with various parties involved in the claims process and may recommend retaining the advice of outside experts as necessary.
- Prepares reserve and settlement authority requests for client and carrier approval.
- May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage.
- Has a solid understanding of claims processing and the insurance brokerage business.
- Has an in-depth understanding of the terminology and case law associated with their specialized claims niche/industry.
- Handles claims consistent with clients' and corporate policies, procedures and "best practices" and in accordance with any statutory, regulatory, and ethical requirements.
- Provides guidance and/or supervision to lower-level adjusters. Incumbents at this level should be able to work at full case load capacity
Additional Considerations: Investigate, evaluate, and resolve construction defect claims while engaging with our clients Required:
- 5 or more years related claims experience required.
- Demonstrated ability to handle unique/challenging claims issues at a senior adjuster level.
- 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: JD preferred
- 10 or more years of prior experience adjusting claims in applicable specialty area preferred.
- Insurance carrier or TPA experience with the ability to interpret construction liability policies and conduct claim and litigation management
Work Traits:
- Ability to think critically, solve problems, plan, and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges.
- Analytical skills necessary to make decisions and resolve issues inherent in handling of claims.
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