Claims Specialist II - Major Case

The Claims Specialist II - Major Case position is primarily responsible for investigating, evaluating, negotiating and settling moderate to high complexity claims within our construction defect team. This position requires extensive experience in claims handling. This position is responsible for conducting timely and thorough investigations, verifies applicable coverages, analyzes liability, evaluates damages for reserve and settlement, and negotiates claims to resolution in accordance with claims best practices.

The Claims Specialist II position promotes a positive work environment encouraging their team members to be the best they can be and are willing to take on additional challenges as needed. They buy into a strong service mentality for both internal and external customers. This position requires a high EQ, strong soft skills and technical skills, strong communication skills, attention to detail, and the ability to handle multiple tasks efficiently and effectively.

UFG is willing to consider hiring at Claims Specialist I, II, or III dependent upon experience and technical expertise.

Responsibilities :

• Review new claims assignments to determine the nature of the claim and action required.
• Review and interpret applicable policy coverages. If coverage issues are present, draft detailed coverage disclaimer or Reservation of Rights.
• Make prompt, meaningful contact with insureds, claimants, witnesses and other parties of interest.
• Conduct a timely and thorough investigation to identify liability exposures and damages through securing recorded
• statements, compiling and reviewing investigation reports, reviewing property damage estimates and / or proofs, and securing and reviewing other evidence where the investigation leads you and in accordance with claims best practices.
• Document all file activity through detailed file notes and prepare reports for the claim file per claims best practice guidelines.
• Evaluate damages and recommend reserves per reserve timeliness and accuracy guidelines.
• Develop and execute negotiation strategies and proactively push claims towards resolution.
• Actively identify subrogation potential and posture claim for successful subrogation recovery.
• Identify risk transfer opportunities and exposures.
• Draft tender letters and place all potential parties on notice.
• Vet, select and retain experts when necessary and approved. Remain aware of and apply expense management initiatives.
• Demonstrate a supportive attitude and presence within the team by adapting well to change in process or procedure. Share innovative ideas to improve work product and outcomes. Take initiative to identify and learn about areas of professional development. Proactively seek out opportunities to collaborate with peers.
• Mentor other Claims Specialists to further their development and technical skills
• 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 :

Certifications / Designations :

Experience :

Knowledge, skills & abilities :

Working Conditions :

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 task and requirements may be assigned, as necessitated by business need. UFG retains the right to modify the description of this job at any time.

Compensation and Benefits :

UFG pays on a geographic salary structure commensurate with skills, credentials and experience of the candidate. The salary range listed of $80,000 - $120,000 is the standard pay structure. Roles in various locations (such as California) may provide an increase on the standard pay structure based on location.

This position is also eligible for an Annual Bonus based on Company / Individual Performance and is at company discretion. Full-time employees are eligible to receive benefits including medical, dental, and vision coverage; 401k, Cash-balance pension, Discretionary Time Off (DTO), paid holidays and more

Salary : $80,000 - $120,000