Claims Specialist I - MCU

UFG is currently hiring for a Claims Specialist I - Major Case who will be responsible for proper investigation, evaluation, and resolution of moderate exposure cases and complex coverage claims in construction defect type losses. This includes reviewing the appropriate policy(ies)along with the endorsements to analyze coverage and communicate our coverage position. The Construction Defect Specialist will need to determine loss facts, extent of damages and setting proper reserves through interviews and document review including expert reports, homeowner matrices, scope of work matrices, defect lists, time on risk matrices and all other relevant documents for the purpose of evaluating, negotiating and settling claims. The claims handled by this position include litigated and non-litigated files. A large component of the job may include proper reporting to corporate personnel and reinsurance programs.

Responsibilities

• Complete initial and subsequent case reviews, review of the allegations, and policy language in order to determine if there is coverage. Keep apprised of changes in legal climate, case law and court procedures in the subject jurisdictions.
• Identify coverage issues, and send corresponding appropriate ROR, declination or other coverage-related written communications to the insured(s) and agency.
• Recognize and pursue risk transfer opportunities and exposures as appropriate, i.e. contractual defense/indemnity and additional insured defense/indemnity. Understand and be able to determine priority of coverage and allocation issues including consecutive, primary vs. excess and concurrent coverage.
• Actively pursue co-carrier contribution and subcontractor participation, including by issuing tenders and pursuing cost sharing arrangements. Pursue subrogation if appropriate.
• Investigate and evaluate liability by considering, identifying and applying available defenses i.e. statutes of limitation and repose, comparative negligence, comparative/pure comparative fault laws, allocation, contribution, immunity laws, anti-indemnification statutes, collateral source laws, and other legal doctrines, as appropriate.
• Complete exposure evaluation to include an allocation of the insured’s respective share of liability for the incident, and the evaluation of damages attributable to it, as well as the extent of covered damages.
• Complete timely reserve evaluation in accordance with UFG’s Gold Standard of claims.
• Complete settlement/negotiation plan, giving objective and well-considered weight to the strengths or weaknesses of case, anticipated rebuttal and counter-arguments, venue climate, verdict potential, and/or projected future costs.
• Notify insured of key developments and demands throughout the case, and communicate with agency and UW departments regarding substantial high-dollar shift in financial exposure.
• Actively drive case resolution momentum and progression and provide a “road map” and explanation for case decisions. Ensure that outcome-based plan and strategy are included in file handling.
• On litigated files, collaborate with defense counsel on a fluid and dynamic basis to explore and identify efficient, cost effective resolution alternative and strategies.
• Direct negotiation, settlement conference, and/or mediation efforts. Assertively create and pursue early settlement opportunities.
• Direct retention of experts and other high-dollar vendors, consistent with documented strategy/objectives.
  
  

Qualifications

Education:

• Four-year college degree preferred
  
  

Certifications/Designations/Licenses

• AIC or similar claims designation preferred.
• Meet the appropriate state licensing requirements to handle “multi-line” claims.
  
  

Experience

• 5 years’ experience in handling casualty claims with 2 years total direct construction defect claims experience.
• Must have a working knowledge of subcontractor construction defect claims, with at least 2 years litigation handling experience.
  
  

Knowledge, Skills & Abilities

• Ability to read, comprehend and interpret policy language, endorsements, and contracts while applying them to the claim. Must understand coverage trigger and allocation theories. Analytical ability to determine coverage and reserves. Understand technical aspects of the construction trade and involved contracts.
• Possess negotiation skills, human relations skills, analytical skills, organization skills as well as oral and written communication skills.
• Ability to document information into appropriate technological format. Prepare and forward notification forms to management and/or underwriting. Maintain contact with supervisor. Answer and respond to phone requests on claims.
• Use mail, email and phone to secure information. Must have analytical judgement to determine and apply negligence laws of state.
• Must have knowledge of the law (civil, contractual), construction and building repair, good knowledge of the various construction trades.
  
  

Working Conditions

• Working out of home or office (general office conditions), and occasional traveling required for attendance at mediations, courthouse, settlement conferences or trials. Occasional site inspections as determined appropriate with your supervisor.
  
  

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this job. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and skills required. Additional tasks and requirements may be assigned, as necessitated by business need. UFG retains the right to modify the description of this job at any time.