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
Investigate, evaluate, and resolve construction defect claims while engaging with our clients
- 7 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.
- 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
- 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.
Ability to successfully negotiate the settlement and disposition of claims including the ability to interpret related documentation