Claims Examiner

Core Specialty Insurance Services•Cincinnati, OH

1d•Hybrid

About The Position

The Claims Examiner will adjust and manage claims brought against security companies, private investigators, and alarm installation and monitoring companies. This role involves handling claims from receipt through resolution, trial, or appeal. Key responsibilities include early contact with the insured, analyzing coverage, communicating with internal and external counsel, managing defense counsel, maintaining claim files, preparing reports, and negotiating settlements. The position requires technical knowledge of third-party liability claims handling and preferred knowledge of first-party commercial auto claims handling. Licenses may be required for adjusting claims in specific states.

Requirements

Bachelor’s degree required.
3 plus years of claims experience preferred.
Previous experience in a similar role.
Applicants must be authorized to work for any employer in the U.S.
Knowledge of third-party liability claims handling required.

Nice To Haves

Knowledge of first party commercial auto claims handling preferred.
Law degree is a plus.

Responsibilities

Adjust and manage claims brought against security companies, private investigators and alarm installation and monitoring companies, from receipt of claim or suit through resolution or trial/appeal.
Provide early contact with insured to identify witnesses, employees, contracts, other relevant documents and to obtain insured’s knowledge of the allegations in the claim/suit.
Analyze coverage for application to claim and prepare coverage position letters including reservation of rights, disclaimers, tender to other parties and acceptance of tenders to insured where appropriate.
Confer with internal and external coverage counsel where necessary to clarify coverage position and coverage litigation.
Communicate with underwriting as to insured’s risk potential and for clarification of policy language intent.
Maintain diaries for file tasks, settlement conferences, mediations, and trial.
Oversee defense counsel from initial assignment of defense and throughout litigation to ensure timely reporting, confirmation of defense strategy and analysis of new developments.
Collaborate with defense counsel to develop early litigation or settlement strategy.
Ensured that Defense Counsel provides timely pretrial reports.
Maintain claim files, notes and documentation which comply with both internal guidelines and external regulations to include analysis of liability, damages, adequacy of reserves and outline of plan or next steps.
Prepare internal reports for file documentation and early identification of significant reserve increases for presentation to management and upper management for review.
Communicate with manager as to critical new developments and significant reserve increase recommendations, and potential settlement recommendations above handler’s settlement authority.
Timely communication and reporting of critical or new developments to exterior carriers including coverage, litigation developments, reserves, and potential settlement opportunities.
Review and approve litigation budgets submitted by Defense Counsel.
Regular review and updating of claim files that remain open but currently inactive and are not generating claim activity.
Evaluate inactive claims for closure and removal of reserves.
Attend mediation and settlement conferences when required to facilitate and negotiate settlement.
Monitor and approve/reject litigation expenses recommended by Defense Counsel.
Prepare settlement drafts and review of releases for accuracy.