Senior Technical Claims Specialist, Construction Complex
- As the claim’s owner, determines coverage, investigates the claims, determines liability, sets and adjusts reserves, evaluates the claim, negotiates a settlement, authorizes and pays the claim; may deny claims.
- Reviews lawsuit documentation and supporting documents, claims file, investigation, etc. Establish actions to be taken to resolve lawsuit.
- Includes determining loss coverage, amounts owed, discovery plans, setting reserves and negotiations.
- Establishes appropriate working team (Home Office Legal, Defense Counsel and Home Office Claims) based on allegations established in suit.
- Responsible for managing the practices and billing activities of outside counsel.
- Accountable for security of financial processing of claims, as well as security information contained in claims files.
- Trains and mentors staff as appropriate; manages relationships and acts as liaison with various business partners (e.g., Underwriting, Reinsurance, Etc.).
- Keeps abreast of existing and proposed legislation, court decisions and trends and experience pertaining to specialty coverage issues.
- May analyze the impact upon claims policies and procedures and advises Claims.
- Management so appropriate action can be taken where required.
- Participates in special projects.
- Bachelor’s degree and 5 to 7 years claims adjusting experience.
- Advanced knowledge of Commercial Casualty claims investigation, coverage evaluation, reserving & expense management, resolution strategy, negotiation, litigation management, claims evaluation as well as the insurance legal and regulatory environment.
- Intermediate to advanced level of skill in the area of customer focus, problem solving, communications, gaining support, teamwork, and adaptability and demonstrated ability to work independently, achieve results and execute thoroughly.
- Construction Liability or Commercial General Liability claims experience preferred.
- California
- Los Angeles Incorporated
- Los Angeles Unincorporated
- Philadelphia
- San Francisco
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