Primarily responsible for the complete handling, including establishing of coverage, liability and
damages, to enable equitable resolutions of all claim assignments. Undertake responsibility for complex
and / or high exposure claim assignments in all lines.
Essential job functions include:
? Responsible for investigation, analysis and evaluation of all claim assignments to include
the issues of coverage, liability and damages.
? Negotiates equitable settlements and produce successful resolutions in accordance with
company policies and department guidelines.
? Exercise independent judgement and employs sound decision making in undertaking the
? Comply with all aspects of the Fair Claims Settlement Practices Regulations.
? Properly document all claim files with dated progress notes and reports to record results
of investigation and handling, stating reasons for decisions and evaluations in
accordance with guidelines.
? Establish and maintain appropriate reserves on all claims that reflect company policies
? Attend settlement conferences, other meetings and hearings as required.
? Assist in reaching company and department objectives by reducing pending files and
successfully concluding all claim assignments, maintains 100% closing ratio.
? Undertake responsibility for re-insurance reporting.
? Analyze and evaluate converge issues and prepare communication on coverage
? Analyze and evaluate complex claim issues and high exposure claims with plans for
implementing resolutions and conducting the activity to reach resolution
? Conduct study and research in related claims areas as may be requested by Claims
? 10 years of claims experience
? Litigation management
? Coverage analysis
? Experience with Commercial transportation, excess liability and complex litigation
? Experience in different jurisdictions preferred
? Ability to do overnight travel for mediation and conferences
? BA required, professional designation preferred
Associated topics: adjuster, casualty, claim, claim adjuster, claim examiner, claimant, insurance, insurance examiner, liability, liability adjuster