General Liability Senior Technical Specialist

Claims Position

Under general supervision, this position is responsible for investigating, evaluating, reserving, negotiating and resolving assigned General Liability Bodily Injury and Property Damage claims. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, litigation management, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. Provides consulting and training resources, and serves as a contact and technical resource to the field and our business partners. This job does not manage staff.

Directly handles assigned severity claims.

Provides quality customer service and ensures file quality and timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case.

Consults with Manager on use of Claim Coverage Counsel as needed.

Directly investigates each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Interview witnesses and stakeholders; take necessary statements, as strategically appropriate.

Complete outside investigation as needed per case specifics.

Actively engages in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts.

Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damage documentation.

Maintains claim files and documents claim file activities in accordance with established procedures.

Utilizes evaluation documentation tools in accordance with department guidelines.

Proactively reviews Claim File Analysis (CFA) for adherence to quality standards and trend analysis.

Utilizes diary management system to ensure that all claims are handled timely.

Establishes and maintains proper indemnity and expense reserves.

Recommends appropriate cases for discussion at roundtable.

Attends and/or present at roundtables/ authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expense.

Actively and enthusiastically shares experience and knowledge of creative resolution techniques to improve the claim results of others.

Applies the Company's claim quality management protocols and Best Practices to all claims; documents the rationale for any departure from applicable protocols with or without assistance.

Develops and employ creative resolution strategies.

Responsible for prompt and proper disposition of all claims within delegated authority.

Negotiates disposition of claims with insureds and claimants or their legal representatives.

Recognizes and implements alternate means of resolution.

Manages litigated claims. Develops litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers.

Applies litigation management through the selection of counsel, evaluation and direction of claim and litigation strategy,

Tracks and controls legal expenses to assure cost-effective resolution.

Effectively and efficiently manages both allocated and unallocated loss adjustment expenses.

Attends depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.

Updates appropriate parties as needed, providing new facts as they become available, and their impact upon the liability analysis and settlement options.

Recognizes cases, based on severity/complexity protocols that should be transferred to another level of claim professional and refers on a timely basis.

Appropriately deals with information that is considered personal and confidential.

Fulfills specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC) instructions and inquiries from agents and brokers.

Represents the company as a technical resource, attends legal proceedings as needed, acts within established professional guidelines as well as applicable state laws.

Actively provides mentoring and coaching to less experienced claim professionals to increase the technical expertise and improve bench strength.

Shares accountability with business partners to achieve and sustain quality results.

Evaluates all claims for recovery potential; directly handles recovery efforts and/or engages and directs Company resources for recovery efforts.

In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.

Perform other duties as assigned.