Sr. Claims Specialist / Commercial
San Diego, CA, USA
Full Time Position + Full Benefits + Excellent Growth Opportunities
Seeking experience complex CL liability including GL, Premises Liability and slips/falls. Also looking for Commercial Property Claims Specialists as well. Should be familiar with either Commercial or Residential Property claims as well. Responsible for Investigation, evaluation, negotiation, disposition and settlement of Property/ Premises and Liability claims, to determine legal liability, damages, and coverage. Assigned claims may involve serious injuries and/or damages, requiring direct involvement in handling complex and high exposure events, litigation and/or mediation of complex issues, requiring minimal supervision. Exceptional evaluation and judgment skills are required to develop all potential exposures in the file, and to properly reserve all indemnity, adjustment, court costs, and legal expenses. Protection of our Client’s and the Company’s financial exposures are critical.
- Analyze and evaluate claims exposure, reserving all exposures to potential value, considering reserve adequacy on each file review and on frequent diary.
- Works independently to establish a work plan to obtain all necessary facts and information, and set the course of action, preparing required documents and reports in compliance with Company and Client requirements.
- Promptly investigate liability claims, obtaining statements from all relevant parties to establish facts, determine liability, and handle to a final conclusion.
- Though primary duties are handled inside, attendance at trial, mediations, and accident site inspections may be required.
- Attend mediations, arbitrations or trials as needed.
- Knowledge of laws and relevant statutes and the ability to apply such to liability policy coverage situations and in dealing with attorneys.
- Training in bodily injury and property damage claims, with the ability to evaluate all elements of damage for each claim type.
- Correspond with customers over the phone, in writing, in person as necessary, obtaining police reports, taking statements, evaluating, and negotiating damage settlements.
- Handling and resolving bodily injury and property damage claims in a "paper-less" claims system that is designed for ease of use and claim file control.
- Document all file activities, negotiations, and evaluations to support decisions, as based on the law and protecting the Client’s and Company’s position.
- Work with defense counsel in litigated files, to develop and control strategies, in consideration of all applicable laws, venue, while controlling costs and determining settlement value versus defense at trial.
- Investigate coverage, liability, compensability and damages with all parties involved in a claim as requested
- Investigate claims by interviewing claimants, witnesses, establish claim reserves, handle evidence, obtain and interpret official reports, medical reports and claim forms, and attend/participate at mediation, trials or hearings.
- Negotiates and settles claims, sets reserves, and manages litigation within client service parameters and authority levels by obtaining demands and making offers to claimants.
- May present evidence at legal proceedings.
- Disposing of salvage and pursuing subrogation when appropriate.
- Prepare reports by collecting and summarizing information required by the client and obtained through investigation.
- Self starter capable of working alone or with others.
- Maintains company reputation and insurance product integrity by complying with Federal, and state regulations,
- Maintain expected case loads in multiple lines of business while meeting established service delivery, production, quality, sales and educational objectives.
- Respond before, after and during work hours to emergency on site claim investigations.
- Maintain professional and technical knowledge through continuing education in multiple lines of business.
- Maintain acceptable product quality through compliance with service standards and compliance with internal quality control initiatives.
- Ability to multi-task in a time sensitive environment and handle job responsibilities with a sense of urgency.