Senior Complex Commercial Property Claims Adjuster

PURPOSE OF THE JOB

The Senior Complex Commercial Property Claims Adjuster is responsible for managing complex claims with a focus on providing the highest level of service for policyholders and ICW Group to independently bring claims to an equitable conclusion within Company standards and best practice guidelines.

Essential Duties And Responsibilities

• Manages and reserves all aspects of an assigned claims inventory to an equitable conclusion.
• Communicates with all relevant parties to the claim including policyholders, agents, attorneys, witnesses or public adjusters to gather information and provide the highest possible level of customer service.
• Investigates claims to determine exposure, works with appropriate experts and makes strategic recommendations.
• Analyzes new and transferred losses to design a plan of action in the management of the claim.
• Maintains a good diary system to ensure timely resolution of claims and compliance with state regulations.
• Ensures accuracy of data in claims system for compliance with applicable regulatory reporting.
• Utilizes appropriate resolution methods (e.g., claim payment, negotiations, denials, etc.) to proactively drive results.
• Operates within the requirements of related state and/or the governing entity rules and regulations as well as internal claims handling policies and procedures.
• Directs defense counsel through the litigation process in accordance with Company litigation guidelines while monitoring legal fees and costs.
• Manages the litigation process and strategizes with defense attorneys.
• Makes recommendations for streamlining processes and adopting the industry’s best practices.
• Collaborates with team members from various departments for project and process discussions.
• Acts as a Subject Matter Expert (SME) for the department and provides expertise to internal and/or external stakeholders.
• Shares knowledge and may train others across the organization.
• Provides training and mentorship for less experienced team members.
• Continuously seeks to improve technical skills by attending job related training and tracking current case law.

Commercial Property Claims (Specific Responsibilities)

• Manages complex high severity claims in multiple jurisdictions or nationwide.
• Analyzes relevant claim documents including policies, estimates, reports, leases, contracts, and bylaws.
• Escalates claim summaries and makes strategic recommendations for approval.
• Researches and analyzes policy language, drafts correspondence with minimal to no guidance for management review.
• Frontloads investigations and moves with urgency by gathering information quickly to assess risk accurately.
• Buils rapport with insureds and their representatives.
• Handles claims against the company and attend related depositions, hearings and settlement conferences as needed.
• Prioritizes early resolution options for every claim and attends resolution proceedings as needed.
• Drafts coverage letters and correspondence with minimal to no guidance for management review.
• Provides advice to underwriters as needed based on inspection reports, including any preexisting damages noted.
• Works to understand and learn the nuances of reinsurance.
• Maintains current knowledge of the Department of Insurance rules and requirements.

Supervisory Responsibilities

This role does not have supervisory responsibilities but may provide claim examiners with training and guidance on the handling of cases; address complaints and resolve problems; coach team members to further their skills and knowledge; promote/encourage adherence to department policies and procedures.

Education And Experience

• Bachelor's degree (or equivalent education/experience) along with a minimum 10+ years of closely related claims experience.

Certificates, Licenses, Registrations

• Commercial Property: Various state adjuster licenses are required. Licenses and certifications may be acquired within a specified timeframe after hire.