Liability Examiner

Job Description

TITLE: General Liability Examiner

DEPARTMENT: Synergy Adjusting

REPORTS TO: Liability Claims Team Leader

STATUS: Regular, full-time; exempt

This is a fully remote position.

SUMMARY OF JOB PURPOSE

The Liability Examiner provides claims examining services critical to Synergy casualty accounts, potentially including those related to niche market clients. The incumbent brings a sound knowledge of insurance coverage related to various business lines. Working closely with a broad scope of stakeholders, the incumbent must be able to handle casualty claims with minimal instruction or supervision. This individual also helps assure that obligations to policyholders are met and that the insurer's reputation and efficacy are safeguarded.

PRIMARY JOB RESPONSIBILITIES

• Determines coverage and identifies coverage issues related to various claims, applying a thorough understanding of applicable insurance policies and relevant coverage and loss types. Issues appropriate Reservation of Rights and/or declination letters.
• Establishes contact and maintains effective professional relationships with insured parties, agents, brokers, public adjusters, attorneys, and others involved in the claims process.
• Reviews claims and claim status with clients and brokers as necessary to facilitate the prompt, accurate resolution of claims filed.
• Obtains and prepares the necessary documentation associated with the prompt, accurate, and thorough verification of losses and administration of claims.
• Follows established policies, procedures, and processes in preparing information, and submits reports and documents in a timely manner and in accordance with insurer's standards and expectations.
• Ensures the accuracy of information collected, and reported, and guards against fraudulent claims.
• Well versed in all facets of coverage determination, investigation, reserving, negotiation, and settlement along with overall claim strategy.
• Reviews, interprets, and evaluates medical bills and/or reports to determine damages and settlement evaluation.
• Manages litigation activities, budgets, and claim outcomes while considering the overall impact to the customer and company.
• Maintains a high level of communication internally and externally with clients, claimants, and attorneys; timely reporting to primary and excess carriers.
• Analyzes contracts and agreements for risk transfer.
• Assesses subrogation potential of losses and recommend files to subrogation adjusters as appropriate.
• Stays abreast of industry information, development, and trends.
• Participates in special assignments and activities as required or approved; demonstrates initiative in the interest of the client and the organization.
• Maintains the confidentiality of proprietary and sensitive information, exercising sound judgment and discretion in any disclosure of information related to Engle Martin and its endeavors.
• Upholds the values of Engle Martin and Our Foundation.
• Adheres to all applicable state insurance regulations and requirements and other applicable laws, regulations, and standards; assumes personal responsibility for maintaining a current state adjusting license.

REQUIRED EDUCATION & EXPERIENCE

• At least 5-10 years of experience as a claims professional with technical competence in handling casualty claims, SIR programs, and the Lloyd's of London market
• Valid NY Adjuster's license
• Bachelor's degree in a related field, or demonstration of equivalent knowledge and critical thinking skills
• Active license or ability to obtain such in multiple jurisdictions within expected time frame

DESIRED KNOWLEDGE, SKILLS & ABILITIES

• Ability to handle moderate to severe casualty claims with a medium to large level of complexity
• Strong litigation management skills
• Detail-oriented, analytical, and the ability to research, investigate and problem solve
• Excellent written and verbal communication skills
• Demonstrates effective interpersonal, collaboration and listening skills to interpret client needs and drive results
• Sound knowledge base and experience with property, general, auto, product, professional liability claims, and construction defect
• Negotiating, conflict resolution, and persuasion abilities
• Trustworthiness, integrity, and personal accountability, and adherence to standards of ethical behavior and professional conduct
• Keen service orientation and ability to grasp and respond to varying client needs
• Effective time management and organization skills
• Basic mathematical and statistical skills
• Ability to interpret policies and other written technical information
• Commitment to confidentiality and ability to discretely handle sensitive information
• Skills in using word-processing, spreadsheet, and database software

WORKING CONDITIONS

General working conditions are typically those associated with an indoor office environment; though evening, overnight, and weekend travel may be occasionally required; on-site work may be required during catastrophic events, subjecting incumbent to indoor and/or outside weather and environmental conditions.

PHYSICAL ACTIVITIES AND REQUIREMENTS

In addition to the working conditions and associated physical activities and requirements above, the incumbent is required to stand, walk, reach, finger, grasp, and feel.

The work requires close visual acuity, with or without correction, to prepare reports containing words, symbols, and numerical figures; the incumbent is required to view a computer terminal, use a keyboard, read printed documents, make detailed visual inspections, perceive color, perceive depth, and have a sufficient field of vision to carry out all inspection and related duties.

The incumbent must be able to speak clearly. The incumbent must be able to perceive the nature of sounds at normal speaking levels with or without correction and to receive and impart detailed information through oral communication, making fine discriminations in sound.