Our Client, a Business Solutions company, is looking for a Claims Adjuster - General Liability for their Chicago, IL location.
Responsibilities:
Claim Investigation & File Ownership:
Independently investigate and manage a full caseload of CGL claims, including but not limited to premises liability, slip and fall, product liability, construction defect and construction-related losses, and contractual liability exposures.
Drive timely claim resolution through proactive file management, strategic planning, and adherence to best practices in diary management and documentation.
Coverage Analysis & Policy Interpretation:
Analyze complex policy language, including insuring agreements, endorsements, exclusions (e.g., ongoing/completed operations, additional insured provisions), and limits to determine coverage applicability.
Draft clear, defensible coverage position letters, including reservation of rights and denial letters, consistent with jurisdictional requirements and client expectations.
Review and analysis of incident reports, contracts, lease agreements, and indemnification provisions
Identification and application of contractual risk transfer provisions
Obtaining and evaluating recorded statements, expert opinions, photographs, and surveillance
Evaluate injury severity, medical treatment, and long-term exposure, including review of medical records, bills, and independent medical evaluations (IMEs) where applicable.
Establish, maintain, and adjust reserves in accordance with claim developments and severity exposure.
Litigation Management:
Manage litigated files, including the retention and direction of defense counsel.
Provide strategic oversight on litigation plans, budgets, pleadings, discovery, and dispositive motions.
Participate in mediations, settlement conferences, and trial preparation, ensuring alignment with client and organizational strategies.
Settlement & Negotiation:
Negotiate settlements within delegated authority while balancing cost containment and risk exposure.
Evaluate settlement value based on liability, damages, venue, and litigation risks, and escalate appropriately when exceeding authority.
Risk Transfer & Subrogation:
Identify, evaluate, and pursue risk transfer opportunities, including:
Additional insured tenders
Contractual indemnity provisions
Subrogation potential
Coordinate with coverage counsel, carriers, and third parties to maximize recovery and proper allocation of liability.
Client & Stakeholder Communication:
Maintain proactive, professional communication with insureds, claimants, brokers, clients, and internal stakeholders.
Provide detailed status updates, large loss reports, and claim summaries tailored to client-specific reporting requirements.
Documentation, Compliance & Quality:
Maintain thorough, accurate, and timely file documentation to support claim decisions and audit readiness.
Ensure compliance with applicable state regulations, client service instructions, and internal audit and quality standards.
Participate in internal and external audits, file reviews, and continuous improvement initiatives.
Additional Functions and Responsibilities:
Support organizational quality initiatives, audit programs, and operational excellence efforts.
Contribute to process improvement, knowledge sharing, and team development activities as needed.