Construction Defect Major Case Specialist - Orlando, FL

About the role

This role is eligible for a sign on bonus up to $20,000. Under general supervision, this position is responsible for investigating, evaluating, reserving, negotiating and resolving assigned serious and complex Construction Defect and Property Damage claims.

Responsibilities

• Directly handle assigned severe claims.
  • Full damage value for average claim (without regard to coverage or liability defenses): $500,000 to several million dollars, amounting to a typical inventory of claims with FDV of over a multi-million dollar value.
  • Provide quality customer service and ensure file quality, timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case.
  • Work with Manager on use of Claim Coverage Counsel as needed.
  • Directly investigate each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential.
  • Interview witnesses and stakeholders; take necessary statements, as strategically appropriate.
  • Complete outside investigation as needed per case specifics.
  • Actively engage in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts.
  • Verify the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation.
  • Maintain claim files and document claim file activities in accordance with established procedures.
  • Develop and employ creative resolution strategies.
  • Responsible for prompt and proper disposition of all claims within delegated authority.
  • Negotiate disposition of claims with insureds and claimants or their legal representatives.
  • Recognize and implement alternate means of resolution.
  • Manage litigated claims.
  • Develop litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers.
  • Utilize evaluation documentation tools in accordance with department guidelines.
  • Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis.
  • Utilize diary management system to ensure that all claims are handled timely.
  • Evaluate liability and damages exposure at required time intervals.
  • Establish and maintain proper indemnity and expense reserves.
  • Provide guidance to underwriting business partners with respect to accuracy and adequacy of, and potential future changes to, loss reserves on assigned claims.
  • Recommend appropriate cases for discussion at roundtable.
  • Attend and/or present at roundtables/authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expense.
  • Actively and enthusiastically share experience and knowledge of creative resolution techniques to improve the claim results of others.
  • Apply the Company's claim quality management protocols, and metrics to all claims; document the rationale for any departure from applicable protocols and metrics with or without assistance.
  • Apply litigation management through the selection of counsel, evaluation.
• Potential for travel up to 30%

Requirements

• Bachelor's Degree.
• 10+ years claim handling experience with 5-7 years experience handling serious injury and complex liability claims.
• Extensive working level knowledge and skill in various business line products.
• Excellent negotiation and customer service skills.
• Advanced skills in coverage, liability and damages analysis with expert understanding of the litigation process in both state and federal courts, including relevant case and statutory law and procedure; expert litigation management skills.
• Extensive claim and/or legal experience and thus the technical expertise to evaluate severe and complex claims.
• Able to make independent decisions on most assigned cases without involvement of supervisor.
• Openness to the ideas and expertise of others and actively solicits input and shares ideas.
• Thorough understanding of commercial lines products, policy language, exclusions, ISO forms and effective claims handling practices.
• Demonstrated strong coaching, influence and persuasion skills.
• Advanced written and verbal communication skills are required so as to understand, synthesize, interpret and convey, in a simplified manner, complex data and information to audiences with varying levels of expertise.

Qualifications

• High School Degree or GED required; In order to perform the essential job functions of this job, acquisition and maintenance of Property/Causalty Adjuster License(s) may be required to comply with state and Travelers requirements. Generally, license(s) are required to be obtained within three months of starting the job.