Complex Case Unit

About the role

Responsible for providing a high level of technical knowledge while working as a critical resource on complex commercial claims and coverage issues.

Major Accountabilities

• Verify coverage/coverage primacy as new losses are received.
• Adjust complex claims with significant and potentially excess exposure, including investigating, evaluating, negotiating, documenting, and validating to conclusion within authority level.
• Evaluate options on problematic files and choose the best solutions.
• Collaborate internally regarding complex coverage issues and claims resolution.
• Monitor and manage approved independent adjusters and attorneys in the field, including attorneys assigned in the defense of the insured.
• Attend mediations and trials as a representative of the Company.
• Communicate with interested parties (i.e., insured, claimants, agents, attorneys, reinsurers) in a professional manner.
• Establish and maintain reserves and communicate with management on a consistent basis.
• Assist in developing technical knowledge within the department.
• Function as a resource for team questions and/or training of new employees as assigned by management.
• Perform other duties as assigned by management.

Qualifications

• Education/Training Requirements: Bachelor’s Degree required. Professional insurance designation preferred. Adjuster licensing required.
• Experience/Specialized Skills: Minimum 10 years’ experience adjusting bodily injury claims required. Experience adjusting commercial auto claims required. Experience adjusting transportation (trucking) liability claims preferred. Advanced knowledge of insurance and tort law, advanced understanding of legal principles and terminology as it relates to insurance operations, and advanced knowledge of medical terminology and procedures required. Advanced knowledge of insurance coverage required. Intermediate computer skills (word processing, spreadsheets, databases, Internet, e-mail) required.