Claim Examiner Or Associate Claim Examiner - Personal Lines And Excess Claims

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Claim Examiner or Associate Claim Examiner - Personal Lines and Excess Claims
The candidate will assist in coverage is confirmed by reviewing the first notice of loss, checking all available systems, and interpreting policy language. Upon coverage analysis, will prepares initial position letters to the policyholder such as disclaimers and reservation of rights. Once coverage is confirmed, the examiner conducts a thorough and focused investigation of the claim. The investigation includes securing all pertinent facts, statements & documents, identifying joint tortfeasors and witnesses, as well as a scene investigation. Initial reserves are posted, reviewed and maintained as the file develops to properly reflect ultimate exposure based on liability and damage evaluation. The examiner is responsible for proactive file management toward final disposition via an effective diary, direction to defense counsel & independent adjusters, analysis & strategy leading to negotiated settlement or trial. Substantive file documentation in claim notes should reflect file activity. While the claim is pending, communication includes delivery of comprehensive and concise authority requests, reinsurance reports, serious loss reports, coverage position letters and appropriate communication with underwriting and actuary. In addition to the essential functions, an examiner is expected to support customer service by responding the same day to phone and email both internally and externally and adhere to established claim service promises. The position may entail the completion of special projects. There is an expectation for enrollment in continuing education to maintain state licenses and to support both professional and personal development as outlined in the annual Individual Development Plan. Some travel is required to attend mediations and/or mandatory court hearings. Should have strong oral and written communication skills, insightful analytical skills, effective negotiation skills, strong organizational and time management skills, and technical knowledge of insurance coverage, negligence law and claim evaluation. Must have 2+ years (Associate Claim Examiner) or 7+ years (Claim Examiner) of relevant experience handling general liability/casualty/excess matters, including prior examiner, adjuster, paralegal, attorney/lawyer and/or other transferable experience. Excess liability experience, multi-jurisdictional knowledge, advanced degrees and/or JD are a plus.

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