What are the responsibilities and job description for the Senior Claims Examiner position at Core Specialty Insurance Services, Inc.?
Adjust and manage claims brought against products liability and general liability insureds, from receipt of claim or suit through resolution or trial / appeal.
Key Accountabilities / Deliverables :
Provide early contact with insured to identify witnesses, employees, contracts, other relevant documents and to obtain insured’s knowledge of the allegations in the claim / suit.
Analyize coverage for application to claim and prepare coverage position letters including reservation of rights, disclaimers, tender to other parties and acceptance of tenders to insured where appropriate.
Communicate with underwriting as to insured’s risk potential and for clarification of policy language intent.
Maintain diaries for file tasks, settlement conferences, mediations, and trial.
Oversee defense counsel from initial assignment of defense and throughout litigation to ensure timely reporting, confirmation of defense strategy and analysis of new developments. Collaborate with defense counsel to develop early litigation or settlement strategy. Ensure that defense counsel provides timely reporting pursuant to litigation guidelines.
Maintain claim files, notes and documentation which comply with both internal guidelines and external regulations to include analysis of liability, damages, adequacy of reserves and outline of plan or next steps.
Prepare internal reports for file documentation and early identification of significant reserve increases for presentation to management and upper management for review.
Communicate with manager as to critical new developments and significant reserve increase recommendations, and potential settlement recommendations above handler’s settlement authority.
Timely communication and reporting of critical or new developments to exterior carriers including coverage, litigation developments, reserves, and potential settlement opportunities.
Review and approve litigation budgets submitted by defense counsel.
Regular review and updating of claim files that remain open but currently inactive and are not generating claim activity. Evaluate inactive claims for closure and removal of reserves.
Attend mediation and settlement conferences when required to facilitate and negotiate settlement.
Monitor and approve / reject litigation expenses recommended by defense counsel.
Prepare settlement drafts and review of releases for accuracy.
This role may require occasional travel for matters that cannot be handled through video conference.
Technical Knowledge and Understanding :
Licenses to be obtained where required by a state to adjust claims within that state.
Knowledge of third-party liability claims handling and risk transfer analysis / coverage analysis required.
Knowledge of products liability claims preferred.
Experience :
Bachelor’s degree required.
JD Preferred.
Minimum 5 plus years of claims experience preferred.
Previous experience in a similar role.
Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa for this position.
LI-Hybrid
At Core Specialty, you will receive a competitive salary and opportunities for professional development and advancement. We offer medical, dental, vision, and life insurances; short and long-term disability; a Company-match of 100% of a 6% contribution 401(k) plan; an Employee Assistance Plan; Health Savings Account, Flexible Spending Account, Health Reimbursement Account, and a wellness program
