Investigates, evaluates and resolves complex and litigated Automobile and General Liability claims for the insurance company. Provide a superior level of customer service to internal and external business partners. Administers and resolves claims in a timely manner and in accordance with client, company and regulatory guidelines. This position is typically assigned claims of highest loss exposures, more difficult coverage and excess issues and includes a diary of predominantly litigated professional liability losses.
Promptly investigate all assigned claims for coverage, liability assessment, damages evaluation and subrogation/contribution potential. Ensure timely disposition of all claims in accordance with regulatory and statutory requirements.
Within granted authority, establish appropriate loss and expense reserves with documented rationale. Maintain and adjust reserves over the life of the claim to reflect changes in exposure. Notify appropriate claim management when exposure exceeds authority. Negotiate claims resolution within granted authority.
Establish and execute appropriate action plans for claim resolution including loss cost management while achieving appropriate financial balance between allocated expense and loss outcome.
Comply with Special Handling Guidelines of Insured.
Work collaboratively with multiple internal and external professionals and business partners in investigating and reaching appropriate disposition of all claims.
Select and manage service vendors to achieve resolution with managed loss and expense payments.
Maintain a very strong working knowledge of applicable regulatory and jurisdictional requirements.
Demonstrate technical proficiency through timely, consistent execution of best claim practices and established claims handling guidelines.
Communicate effectively with internal and external customers on claims and account issues.
Maintain and manage a diary system and claim pending to efficiently and effectively resolve all claims.
Effectively manage litigation process and defense counsel to ensure timely and cost effective outcomes.
Participate with claims management in the counsel evaluation process of staff and panel counsel. Make recommendations for the addition and removal of panel counsel.
Participate with account in the management of their litigation management program.
Attend depositions, mediations, settlement conferences and trials as necessary.
Prepare and submit claim status and reinsurance reports.
Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.
Bachelor's' degree required
A minimum of 10 years of progressively responsible experience in handling complex Automobile and General Liability claims required.
Obtains and maintains state adjusting licenses, as appropriate.
Ensures that all state-required Continuing Education Credits are obtained as needed to maintain license.
Strong and advanced level of expertise in commercial multi-line, multi-jurisdictional coverage, negligence principles, investigation, evaluation and negotiation techniques.
Strong organizational skills and detail oriented.
Ability to work independently, prioritize workload, handle multiple tasks simultaneously and exercise good judgment.
Excellent verbal and written communication skills, including a strong ability to actively lead or participate in meetings, presentations and conferences.
Excellent customer service skills, with emphasis on accessibility and responsiveness.
Computer literacy, including working knowledge of MS Office including Word, Excel and PowerPoint.
Ability to manage claims in a paperless environment.
Demonstrated ability in litigation management skills and extensive knowledge of applicable statutory regulatory and legislative decisions.
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