General Liability Examiner

Primary Job Responsibilities

• Determines coverage and identifies coverage issues related to various claims, applying a thorough understanding of applicable insurance policies and relevant coverage and loss types.
• Issues appropriate Reservation of Rights and/or declination letters.
• Establishes contact and maintains effective professional relationships with insured parties, agents, brokers, public adjusters, attorneys, and others involved in the claims process.
• Reviews claims and claim status with clients and brokers as necessary to facilitate the prompt, accurate resolution of claims filed.
• Obtains and prepares the necessary documentation associated with the prompt, accurate, and thorough verification of losses and administration of claims.
• Follows established policies, procedures, and processes in preparing information, and submits reports and documents in a timely manner and in accordance with insurer’s standards and expectations.
• Ensures the accuracy of information collected, and reported, and guards against fraudulent claims.
• Well versed in all facets of coverage determination, investigation, reserving, negotiation, and settlement along with overall claim strategy.
• Reviews, interprets, and evaluates medical bills and/or reports to determine damages and settlement evaluation.
• Manages litigation activities, budgets, and claim outcomes while considering the overall impact to the customer and company.
• Maintains a high level of communication internally and externally with clients, claimants, and attorneys; timely reporting to primary and excess carriers.
• Analyzes contracts and agreements for risk transfer.
• Affirms subrogation potential of losses and recommend files to subrogation adjusters as appropriate.
• Stays abreast of industry information, development, and trends.
• Participates in special assignments and activities as required or approved; demonstrates initiative in the interest of the client and the organization.
• Maintains the confidentiality of proprietary and sensitive information, exercising sound judgment and discretion in any disclosure of information related to Engle Martin and its endeavors.
• Upholds the values of Engle Martin and Our Foundation.
• Adheres to all applicable state insurance regulations and requirements and other applicable laws, regulations, and standards; assumes personal responsibility for maintaining a current state adjusting license.

Required Education & Experience

• At least 5-10 years of experience as a claims professional with technical competence in handling casualty claims, SIR programs, and the Lloyd’s of London market.
• Valid NY Adjuster's license.
• Bachelor’s degree in a related field, or demonstration of equivalent knowledge and critical thinking skills.
• Active license or ability to obtain such in multiple jurisdictions within expected time frame.

Desired Knowledge, Skills & Abilities

• Ability to handle moderate to severe casualty claims with a medium to large level of complexity.
• Strong litigation management skills.
• Detail-oriented, analytical, and the ability to research, investigate and problem solve.
• Excellent written and verbal communication skills.
• Demonstrates effective interpersonal, collaboration and listening skills to interpret client needs and drive results.
• Sound knowledge base and experience with property, general, auto, product, professional liability claims, and construction defect.
• Negotiating, conflict resolution, and persuasion abilities.
• Trustworthiness, integrity, and personal accountability, and adherence to standards of ethical behavior and professional conduct.
• Keen service orientation and ability to grasp and respond to varying client needs.
• Effective time management and organization skills.
• Basic mathematical and statistical skills.
• Ability to interpret policies and other written technical information.
• Commitment to confidentiality and ability to discretely handle sensitive information.
• Skills in using word-processing, spreadsheet, and database software.