Claims Examiner-Personal Lines

We are seeking a Claims Examiner who is both an analytical and creative problem solver—someone who can pinpoint key issues related to coverage, liability, and damage evaluation. Our ideal candidate is an assertive decision-maker with a talent for persuasive negotiation and conflict management. Every claim presents unique challenges, offering ongoing opportunities to learn and grow, even for seasoned professionals. Our collaborative environment—with frequent interactions with underwriting, compliance, and actuarial teams—ensures that our products remain robust and healthy.

Essential Functions:

• Coverage Verification: Review the first notice of loss, utilize all available systems, and interpret policy language to confirm coverage.
• Position Letter Preparation: Following coverage analysis, prepare initial position letters (e.g., disclaimers and reservation of rights) for the policyholder.
• Claim Investigation: Once coverage is confirmed, conduct a thorough investigation that includes gathering all pertinent facts, statements, and documents, identifying joint tortfeasors and witnesses, and performing scene investigations.
• Reserve Management: Post initial reserves and continuously review and update them as the file develops, ensuring they accurately reflect ultimate exposure based on liability and damage evaluations.
• File Management & Negotiation: Proactively manage the file using an effective diary system, provide direction to defense counsel and independent adjusters, and develop analysis and strategies leading to a negotiated settlement or trial. Maintain substantive claim notes to reflect all file activity.
• Communication: While the claim is pending, deliver comprehensive and concise authority requests, reinsurance reports, serious loss reports, and coverage position letters, and maintain effective communication with underwriting and the actuarial team.

Other Duties and Responsibilities:

• Customer Service: Respond to phone calls and emails (both internally and externally) on the same day, in accordance with established claim service standards.
• Special Projects & Continuous Learning: Complete special projects as assigned, and enroll in continuing education programs to maintain state licenses and support professional and personal development as outlined in the annual Individual Development Plan.
• Travel: Occasional travel is required for mediations and mandatory court hearings.

Specific Skills:

• Excellent oral and written communication
• Strong analytical and organizational skills
• Effective negotiation skills and the ability to manage conflicts
• Technical expertise in insurance coverage, negligence law, and claim evaluation

Minimum Job Requirements:

• Associate Claims Examiner: 2 years of relevant experience handling general liability, casualty, or excess matters (e.g., as an examiner, adjuster, paralegal, or other transferable roles)
• Claims Examiner: 7 years of relevant experience
• Experience in personal lines, multi-jurisdictional knowledge, and advanced degrees and/or a JD are a plus

Passion and drive can be just as important as experience. If you’re excited about this opportunity, we’d love to hear from you!

This position allows for up to 5 days per month of remote work.

At USLI, we are committed to fostering a vibrant and inclusive community that celebrates the rich diversity of all ethnicities, nationalities, abilities, genders, gender identities, sexual orientations, ages, religions, socioeconomic backgrounds, and life experiences. We understand the importance of continuous learning, self-reflection, acknowledging our biases, and expanding our perspectives beyond our own. We actively encourage open dialogue on diversity, equity, inclusion, and belonging to support a workplace where every individual feels valued, respected, and empowered to contribute at their fullest potential. Join us in building a diverse and inclusive environment where our shared values drive us toward excellence.

Job Type: Full-time

Expected hours: 35 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance
• Referral program
• Vision insurance

Schedule:

• Monday to Friday

Work Location: In person