Commercial Auto & GL Claims Examiner II

Tristar Insurance•Philadelphia, PA

2d•$75,000 - $85,000•Remote

About The Position

Responsible for the prompt review and interpretation of policy information to determine coverage for claims involving loss, damage, or injury. Conducts thorough claim investigations and evaluations through final resolution, including claims in litigation. Maintains frequent communication with claimants, legal representatives, clients, defense counsel, and other involved parties. Provides clients with well-supported recommendations regarding claim exposure, reserves, litigation strategy, and settlement. Position is remote/working from home.

Requirements

High school diploma or GED required.
A minimum of five years of experience handling California public entity commercial automobile and general liability claims required.
An equivalent combination of relevant education, training, and progressively responsible claims experience may be considered, provided the candidate possesses the required California public entity claims experience.
Thorough knowledge of California public entity claims laws, statutes, immunities, procedures, and filing requirements.
Knowledge of commercial automobile and general liability coverage, investigation techniques, litigation management, damages assessment, and claim valuation.
Ability to independently analyze complex coverage, liability, causation, damage, and exposure issues.
Advanced analytical, decision-making, negotiation, and problem-solving skills.
Working knowledge of the litigation process, including pleadings, discovery, depositions, mediation, trial preparation, and legal budgeting.
Ability to manage outside counsel and investigative service providers effectively.
Strong verbal and written communication skills, including the ability to prepare professional loss reports and present claim recommendations.
Ability to manage client relationships and provide high-quality service in a fast-paced environment.
Ability to follow detailed written and verbal instructions and respond to requests accurately and efficiently.
Strong organizational, time-management, and prioritization skills.
Ability to manage assigned claims with minimal supervision while meeting applicable deadlines and diary requirements.
Proficiency with claims-management systems and standard business applications, including Microsoft Office.
Ability to exercise sound judgment, discretion, flexibility, initiative, and professionalism.
At least five years of Automobile and General Liability California Public Entity claims experience required.
Should reside in the Sacramento, CA vicinity
Knowledge of California Public Entity claims statutes, handling concepts, practices, and techniques, including but not limited to coverage issues, litigation management and product line knowledge.
Candidate must have a California Adjuster License.

Nice To Haves

Bachelor’s degree in business, insurance, risk management, criminal justice, or a related field preferred.

Responsibilities

Review and interpret policy coverage and investigate, evaluate, negotiate, and resolve assigned commercial automobile and general liability claims.
Apply California public entity laws, statutes, regulations, and claims-handling requirements to assigned matters.
Conduct field investigations and site inspections when required.
Coordinate and direct outside investigative service providers, appraisers, experts, defense counsel, and other vendors.
Work closely with clients, client counsel, and investigative services to advance claims toward timely resolution.
Maintain an accurate and current diary for all assigned claims.
Continually assess claim exposure and establish or recommend accurate reserves and settlement authority.
Prepare comprehensive loss reports that provide a thorough analysis of coverage, liability, damages, exposure, litigation strategy, and recommended resolution.
Identify potential subrogation, contribution, indemnification, or other risk-transfer opportunities and initiate recovery efforts in the client’s direction.
Document all correspondence, reports, discussions, evaluations, and claim decisions accurately and promptly in the claim file.
Attend city council meetings, claim-review meetings, mediations, settlement conferences, site inspections, and other proceedings in person when required.
Prepare and present clear, concise claim summaries and recommendations to clients and other stakeholders.
Maintain compliance with client service instructions, company procedures, regulatory requirements, and industry best practices.
Provide responsive and professional service to clients and other parties involved.
Perform other duties and special projects as assigned.