The Complex Claims Adjuster is responsible for overseeing and evaluating general liability claims, including those with moderate exposure involving litigation. This role ensures that claims are managed in accordance with company standards, industry best practices, and specific client requirements.
Key Responsibilities:
- Claims Evaluation & Management:
- Investigate and assess general liability claims involving property damage and bodily injury to determine potential exposure.
- Develop and implement proactive strategies to resolve claims quickly and cost-effectively through well-structured action plans.
- Coverage Review & Analysis:
- Identify and analyze coverage issues, preparing detailed coverage letters for review.
- Liability Assessment & Resolution:
- Assess liability for each claim and resolve it within the established evaluation framework.
- Ensure timely documentation of claims and maintain accurate records according to department timelines and guidelines.
- Documentation & Compliance:
- Maintain thorough and precise claim files, documenting coverage, damages, reserves, and liability, along with a clear resolution plan.
- Complete all tasks and documentation within required timeframes and ensure compliance with department policies.
- Litigation Involvement:
- Represent the company in arbitrations, mediations, settlement conferences, and trials as necessary.
Required Qualifications:
- Completion of State licensing exams and ongoing education as required.
- Experience in managing complex claims, including those with litigation and moderate exposure.
