BI Adjuster

BODILY INJURY ADJUSTER POSITION SUMMARY:

The attorney represented bodily injury specialist will be responsible for the investigation, evaluation, negotiation, disposition and settlement of auto liability claims, to determine legal liability, damages, and coverage. Assigned claims will involve serious injuries and/or damages, requiring direct involvement in handling complex issues and high exposure events, with minimal supervision. Exceptional evaluation and judgment skills are required to develop all potential exposures in the file, and to properly set indemnity reserves. Protection of our Insured’s and the Company’s financial exposures are critical.

RESPONSIBILITIES:

• Assume responsibility for attorney represented and complex injury claims, including serious fractures, fatalities, disfigurements, etc.
• Demonstrate a high level of investigation, analysis, evaluation and negotiation including interpretation of coverages
• Develop injuries and set reserves accurately in accordance with internal guidelines
• Complete Bodily Injury Evaluation forms and make recommendations for the disposition of claims
• Complete serious injury reports as required
• Evaluate policy coverage, contact insureds, claimants, attorneys, body shops and medical staff to determine injuries stemming from an accident while determining and establishing reserve requirements.
• Document computer log with results of review and intentions for handling.
• Plan and conduct investigations (including but not limited to interviewing parties involved, collecting and evaluating documentation and securing evidence and protecting the chain-of-custody, determine inspection needs, order police reports, scene investigation, take witness statements, review material damage photos, order medical reports, etc.) to analyze coverage, determine liability, compensability, and extent of damages.
• Compile information for decision making with discussion of claims committee where appropriate.
• Evaluate the medical injury exposure within guidelines, research & review appropriate statutes and case law for relevance to claim issues, and make appropriate and timely payments.
• Maintain accurate records and handle administrative responsibilities associated with processing and payment of claims. Record and update status notes, and document results of contacts, relevant medical reports and duration information per best practices
• Determine need for independent adjusters, cause and origin experts, independent medical examiners, economists, accident re-constructionists, and engineers.
• Respond timely and appropriately to all settlement demands.
• Keep internal and external customers advised of file status and other matters as required.
• Evaluate claim for potential fraud and work with Special Investigations Unit as required.
• Assess actual damages associated with claims and conduct negotiations to settle claims.
• Determine if subrogation exists and take steps necessary to initiate recovery efforts.

QUALIFICATIONS:

• Attorney Represented Bodily Injury experience required
• Minimum of five (5) years experience handling complex and attorney represented bodily injury claims
• Possesses strong customer service skills and behaviors.
• Makes decisions in an informed, confident and timely manner.
• Maintains constructive working relationships despite differing perspectives.
• Possesses strong organizational and time management skills.
• Ability to negotiate skillfully in difficult situations with both internal and external groups.
• Demonstrates strong written and verbal communication skills. Promotes and facilitates free and open communication.
• Understanding of applicable statutes, regulations and case law.
• Thinks critically and anticipates, recognizes, identifies and develops solutions to problems in a timely manner.
• Easily adapts to new or different changing situations, requirements or priorities.
• Cultivates an environment of teamwork and collaboration.
• Computer experience (MS Office, excel, word, etc)
• Hold valid adjuster license

About Embark

Embark is the smarter, next generation MGA, delivering turnkey insurance solutions to our carrier and distribution partners. Our depth of insurance expertise spans personal auto, personal and commercial property, and professional liability, serving both specialty and broad market opportunities. Led by industry veterans and trailblazers, we have over 150 team members located in offices in California, Georgia, Texas, and remote.

Founded in 2018, Embark is setting a new bar for the value an MGA can bring to agents, distributors, carriers, and reinsurers. We’re also where awesome colleagues and hard problems meet.