Liability Claims Examiner

Job Description

Job Description

We currently have an opening for a Liability Claims Examiner.  The role of Vanguard?s Liability Examiner is to investigate and evaluate insurance claims, determining liability, handling construction defect and managing the claims process, often including litigation and settlement negotiations, to ensure timely and cost-effective resolutions for our clients.

Job Requirements:

• Handling liability and construction defect claims from inception until completion; reviewing liability claims, litigated by counsel or insurance adjuster managed; maintaining a point person role reporting to the proper client and ensuring all time lines are properly followed; resolving claims by denial, settlement or referral to another insurance company.
• Performs complete liability, coverage and bodily injury investigations. Reviews and evaluates claim based on evidence obtained to determine responsible parties, liability exposure, questions of fraud or other pertinent issues.
• Claims in Construction Defects are often involved and require contract analysis, managing litigation/arbitration with numerous defendants and coverage issues that may involve multiple policy years, varied insurers and types of insurance coverage specific to the construction trades industry.
• Reads, analyzes and interprets insurance policies and endorsements, applicable state and local statutes, case law and applies to claim situations
• Orders bills and reports from medical providers of injured parties, obtain police/ambulance/fire reports, medical histories and ISO reports to determine facts and prior accident information
• Prepares and maintains file documentation, communicates with insureds, claimants or attorneys regarding progress of claim. Negotiate settlements of claims with insureds, claimants and others up to authority limits
• Draft reports to clients with recommendations for claim disposition
• Attend Mediations/Arbitrations/Trials as necessary
• Manage legal expenses, reserves and financial transactions
• SOC 2 Compliance Responsibilities
  • Handle all claimant, policyholder, client, and company information in accordance with SOC 2 security, confidentiality, and data integrity standards.
  • Ensure sensitive data is stored, transmitted, and processed securely, following company policies and procedures.
  • Maintain accuracy and completeness of information in all systems, reports, and documentation.
  • Promptly report any actual or suspected security incidents, policy violations, or data handling concerns to management.
  • Participate in training and awareness initiatives to stay current on SOC 2 requirements and best practices.
  • Support audit readiness by providing documentation, evidence, or explanations of compliance activities when requested.
• Performs additional responsibilities as needed to support business operations and compliance objectives.