Complex Claims Specialist
About The Position
Carolina Casualty, a member company of W. R. Berkley Corporation, is seeking a Complex Claims Bodily Injury Specialist. This role is responsible for promptly and professionally ensuring high-quality claim handling by analyzing BI/liability of claim submissions, making coverage determinations, investigating losses, conducting independent assessments of the insured's exposure, and moving cases towards timely resolution. The specialist will serve as an expert resource due to their deep knowledge and liability claim expertise. This high-level adjuster role adjudicates assigned claims within given authority and provides operational support to the claims team.
Requirements
- Bachelor’s Degree
- Demonstrates an advanced knowledge of commercial trucking bodily injury claims case handling practices, legal liability, general insurance policy coverage, and the state's tort laws as normally acquired through a bachelor's degree (or equivalent training) plus 5-10 years directly related work experience.
- Ability to investigate and evaluate complex liability claims.
- Ability to analyze available information and make effective decisions.
- Ability to evaluate damages and negotiate fair settlements.
- Advanced analytical skills.
- Advanced knowledge of coverage within the team’s specialty or focus.
- Litigation and mediation management experience required.
- Excellent verbal and written communication skills.
- Strong background in auto and general liability coverage analysis particularly involving commercial claims with complex issues.
Responsibilities
- Adjusts and resolves complex to severe commercial trucking bodily injury claims that may also include all phases of litigation.
- Plans and conducts investigations of high severity bodily injury claims (including interviewing insureds, witnesses, and claimants, collecting and evaluating appropriate documentation, securing evidence, and protecting chain-of-custody) to analyze and confirm coverage and determine liability, compensability, and damages.
- Determines the need for, and engages, independent adjusters, cause and origin experts, and independent medical examiners.
- Refers claims to the subrogation group or Special Investigations Unit as appropriate.
- Assesses policy coverage for submitted claims and notifies the insured of any issues.
- Drafts complex coverage letters, including reservation of rights and denial letters, with minimal supervision.
- Determines and establishes reserve requirements, adjusting reserves as necessary during claim processing.
- Reviews and analyzes claim documentation and legal filings.
- Assesses actual damages associated with Bodily Injury claims and confidently conducts negotiations within assigned authority limits to settle claims.
- Coordinates litigation activities associated with assigned claims to ensure timely and cost-effective resolution; attends trials as a representative of the company.
- Acts as a senior technical professional on the team, assisting team members with escalated issues.
- Develops and maintains excellent rapport with our agency force, insureds, claimants, experts, attorneys, and internal customers.
- Attends mediations, trials, and performs overnight travel as needed.
Benefits
- competitive compensation plan
- robust benefits package
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What This Job Offers
Job Type
Full-time
Career Level
Senior
