Claims Examiner

Berkley•Jacksonville, FL

10d•Onsite

About The Position

The Claims Examiner will be responsible for the investigation, evaluation, disposition and settlement of bodily injury claims involving commercial automobile losses, including determination of coverage, liability, damages and risk transfer, as well as the timely setting of proper reserves and achievement of prompt, fair and equitable settlements. The role involves overseeing and resolving truck, bus, commercial auto and/or public transportation claims, conducting thorough investigations, and managing consultants to achieve settlements according to fair claims handling requirements. The Claims Examiner will utilize critical thinking and solid judgment to solve problems, make decisions, and resolve complex issues. This position requires planning and organizing activities throughout the claims management process, writing concise reports, and effectively communicating contractual issues and coverage applications. The role involves initiating and overseeing serious automobile accident investigations, developing strategies for better claim results, and accurately assessing commercial auto insurance coverage issues. The Claims Examiner will also draft declination and Reservation of Rights letters, negotiate settlements, present case statuses, and document all claim activities. Experience with Self-Insured Retention (SIR) and PIP claims is a plus.

Requirements

6+ years commercial auto claims adjusting experience.
Adjuster license required.
Excellent written and verbal communication skills.
Excellent organizational and analytical skills with high attention to detail.
Ability to work independently, managing time and resources to accomplish multiple tasks in a fast-paced, deadline-oriented environment.
Strong interpersonal and negotiation skills.

Nice To Haves

Experience with Self-Insured Retention (SIR) is a plus.
Experience with PIP claims is a plus.

Responsibilities

Oversee and resolve truck, bus, commercial auto and/or public transportation claims.
Conduct a prompt, thorough and fair investigation by obtaining relevant facts to determine coverage, origin and extent of losses.
Investigate, determine and evaluate coverage, liability, damages and risk transfer, and set proper reserves in a timely manner.
Control the insured’s exposures and losses, manage consultants and achieve a prompt, fair and equitable settlement according to fair claims handling requirements.
Utilize critical thinking and solid judgment to solve problems, make decisions and resolve complex issues inherent in handling losses.
Plan and organize activities throughout the claim’s management process.
Write concise reports and effectively communicate contractual issues, technical legal concepts and coverage application in easy-to-understand terms.
Act timely upon emerging information to ensure ongoing recognition of the financial exposure on losses within assigned exposure up to $100k, and promptly communicate to management if beyond the assigned level of exposure.
Interpret related claims documentation.
Initiate and oversee serious automobile accident investigations and rapid response.
Develop strategies and effective plans that drive claims to better results.
Accurately assess and resolve commercial auto insurance coverage issues; analyze facts and allegations in conjunction with all policy provisions, endorsements and amendments.
Draft declination, Reservation of Rights and other coverage letters.
Negotiate outstanding settlements.
Present case statuses and summaries in a clear, concise and understandable manner.
Document and communicate all claim activities timely and effectively in a manner that supports the outcome of the claim file.