What are the responsibilities and job description for the Claims Examiner position at Masis Staffing Solutions?
Manages complex, high-value claim and suit files independently. Cases will involve complex coverage, liability, damages and / or injuries. May give technical assistance to staff adjusters. Manages independent adjusters and attorneys assigned to the Examiner’s files. Has settlement authority in excess of adjusters. May extend settlement authority to staff adjusters. Does not administratively supervise staff adjusters.
Essential Duties and Responsibilities :
- Analyze, review, and interpret policies to resolve coverage and assess liability.
- Independently handle more complex and high-exposure Commercial General Liability claims, including claims in litigation and construction defect claims.
- Under general supervision and direction, resolves complex claims by investigating losses, negotiating settlements, presenting evidence in legal proceedings while maintaining adequate production and quality levels.
- Investigates claims by interviewing shipper, consignee, witnesses, requesting and obtaining official reports, requesting, and reviewing survey reports, and comparing claim information with evidence.
- Independently manage files in litigation.
- Establish and maintain proper loss and expense reserves.
- Determine what investigation is necessary to bring a claim to an equitable conclusion for all parties involved.
- Properly document information in the claim file.
- Review insurance policies for coverage and make recommendations.
- Make decisions regarding the liability of an insured.
- Maintain a working diary of assigned claims.
Required Education / Experience :
Basic
Advanced
Licensing :