Claims Examiner / Senior Claims Examiner
The Claims Examiner or Senior Claims Examiner will handle a caseload of commercial insurance claims under a close to moderate level of supervision. Job functions to include: Analyzing claims to determine applicable coverage afforded to the policyholder. Analyzing claims to determine the extent of insurance carrier's liability. Reviewing and evaluating damages and making recommendations for resolution. Settling claims with claimants in accordance with policy provisions and within authority. The Claims Examiner / Senior Claims Examiner will ensure that state claims handling requirements are met and internal guidelines are followed. The Claims Examiner / Senior Claims Examiner will handle claims in accordance with established James River Claims Best Practices. The successful candidate will be an integral member of the claims team and depending on experience level may frequently be called upon to train new Claims Examiners and manage more complex coverage issues and complex litigation.
Duties & Responsibilities:
- Performs coverage, liability, and damage analysis on all claims assignments.
- Investigates all aspects of claims files
- Drafts disclaimers and reservation of rights letters
- Assigns limited investigations and appraisals to independent adjusters located nearest to the claim location.
- Refers litigation matters to defense counsel or to coverage counsel with approval of Claims Manager.
- Negotiates settlements, mitigates losses, and controls expenses within authority.
- Manages litigated files
- Maintains a high level of communication internally with Claims Manager and team members as well as externally with insureds, claimants and brokers.
- Provides technical guidance, assistance and training to co-workers.
- Mandatory college degree
- Claims Examiner: A minimum of 3 years of claims handling experience. Experience in working with liability coverage issues. Has multi-jurisdictional claims experience.
- Senior Claims Examiner: A minimum of 10 years of claims handling experience.
- Excellent verbal and communication skills
- Well organized and possessing computer skills
- Claims adjuster license and/or certifications desired but not required.
- Possesses functional knowledge and skills reflective of a fully competent Claims handler.
- Strong analytical skills
- Strong negotiation skills
- Ability to work independently
- Ability to work within a specific authority on assignments with a moderate technical complexity and exposure.
To apply for this position, please email your resume and cover letter to: