Claim Examiner Or Associate Claims Examiner-employment Practices

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Claim Examiner or Associate Claims Examiner-Employment Practices
The candidate will be responsible for confirming coverage by reviewing the first notice of loss and policy information. Will prepare coverage position letters such as disclaimers and reservation of rights. Once coverage is confirmed, the examiner conducts a thorough and focused investigation of the claim to assess liability and damages. Must understand and applicable statutory and case law to assess liability exposure. Should identify joint tortfeasors and ensure all parties pay their fair share. Examiners are responsible for maintaining adequate reserves as the claim develops to properly reflect ultimate exposure based on liability and damage evaluation. Responsible for proactive file management toward final disposition via an effective diary, directly negotiating claims with a claimant or claimant attorney, overseeing defense counsel to ensure effective litigation management with established guidelines and reviewing/approving settlement agreements. Must maintain substantive file notes that document all relevant claim activity. Responsible for preparing comprehensive and concise reserve authority requests, reinsurance reports, serious loss reports, coverage position letters, as well as reports to underwriting and other departments. 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. May entail the completion of special projects. Must have an understanding of legal concepts, litigation processes and agency filings. 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, employment law and claim evaluation. Must have 2+ years (Associate Claim Examiner) or 7+ years (Claim Examiner) of relevant experience handling liability matters, including prior examiner, adjuster, paralegal, attorney/lawyer and/or other transferable experience. Employment practices, D&O and or E&O claim experience, multi-jurisdictional knowledge, advanced degrees and/or JD, are a plus.

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