POSITION SUMMARY:

The Specialty Casualty Senior Claims Examiner is responsible for investigating and evaluating losses, expense and coverage as bears to policies issued under Commercial General Liability program for which there is an exposure of high value or contains intricate coverage knowledge and evaluation. Be well educated in coverage to be able to evaluate and cite offered coverage, and any limitations thereto in both oral and written communications. Develop investigation plans and defense strategies which are unique to each claim. Investigate and negotiate the resolution of claims within pre-determined authority. Recommend and monitor loss and expense reserves as authorized by client.

RESPONSIBILITIES:

• Manage daily workflow to effectively process claims in a timely manner. This includes adherence to a diary system for claims handling.
• Instruct and manage third-party investigative staff and attorneys to ensure proper handling of claims. This includes review and negotiation of vendor invoices as necessary.
• Exercise sound judgment in setting reserves and negotiating settlements within personal authority level. Present facts and recommendations to Claims VP for any files outside of personal authority level.
• Investigate claims through verbal and written communications with named insureds and third parties.
• Evaluate coverage as bears to a claim and be able to articulate the coverage position verbally and in writing to interested parties.
• Be educated in and adhere to regulatory rules unique to each venue in which the Company handles claims.
• Travel on behalf of carrier as needed, approximately 20% of time.
• Stand in shoes of manager during absence as bears to file assignment, assistance to peers, damage review and provision of authority to settle claims as necessary.
• Perform other activities, duties and assignments as needed or requested.
• Eligible for remote or hybrid work arrangement.

QUALIFICATIONS:

• Knowledge of commercial casualty insurance concepts and principles.
• Understanding and adherence to the philosophy of the carrier to properly service claims.
• Excellent communication skills, both oral and written.
• Proficiency in use of Microsoft Office suite of products and ability to learn other software as needed.
• Professional communication skills and timely claims handling required.
• College degree preferred or related insurance experience.
• Seven to ten years claims handling experience.