Claims Major Case Director

Responsibilities

• Handles highly complex exposure claims based on Claim Guidelines.
• Selects, directs and manages defense counsel including approval of budgets.
• Develops litigation/file disposition strategy.
• Attends mediations, settlement conferences and trials.
• Reports to reinsurers as required by reporting guidelines.
• Affixes All Time Limit Demands to be escalated to management.
• Assists Sr. Claim specialists with analysis of claim issues as needed.
• Verifies/analyzes applicable coverage for the reported loss.
• Establishes 24-hour contact and maintain appropriate contact with all involved stakeholders throughout the life of the claim file.
• Investigates each claim by gathering information, conducting interviews, taking statements, conducting website research as needed, reviewing and analyzing reports and related bills.
• Identifies and addresses subrogation/contribution/SIU opportunities.
• Sets accurate/timely loss/expense reserves in compliance with Claim Guidelines.
• Negotiates directly with claimants and claimant attorneys upon receipt of critical information.
• Drafts correspondence, including but not limited to, coverage letters to stakeholders as required.
• Maintains resident/nonresident adjuster licenses as required.
• Performs other duties as assigned.

Qualifications

• Bachelor’s degree with a minimum of 12 years of claims handling experience in the insurance industry or equivalent.
• At least 8 years General Liability claim experience as well as Commercial Auto handling, which focused on claims with an exposure of $250,000 or more including both primary and excess losses.
• Excellent coverage analysis skills with experience in drafting coverage position correspondence.
• Extensive experience working with general liability, construction defect, garage, commercial trucking as well as identifying coverage issues.
• Experience handling litigated files and direction of defense counsel.
• Excellent negotiation skills which would be handled primarily by the file handler.
• Able to travel, average 4 days a month.
• Licensure as required by respective states.
• Able to analyze data, utilize sound judgment to draw conclusion and make supported decisions.

Preferred To Have

• CPCU and other insurance related studies.
• Construction Defect claim handling experience.