Senior Claims Analyst
Riverstone Resources
Job Description
Job Description
Reporting to the Unit Manager, this role will be responsible for direct handling of commercial claims specific to General Liability and/or Excess General Liability. Familiarity with SME (small to midsize enterprises) insureds involving premises liability, including but not limited to franchisees, hotels, and restaurants/entertainment. Duties include investigation and evaluation of coverage, liability, risk transfer (i.e. indemnification and/or tender application), and damages issues. The role will be responsible for claim and coverage evaluation, establishment/recommendation of adequate reserves, litigation management, liability and damage analysis in detail, case resolution and best claims outcome, and transaction processing in alignment with the Company’s and Client’s Strategic Vision.
Essential Functions
- Direct handle commercial and business general liability claims.
- Mentors and guides less experienced claim analysts.
- Assists the Unit Manager with departmental problem solving.
- Manages external relationships including third party administrative oversight.
- Serves on Companywide committees and projects as assigned.
- Anticipates and identifies risks and opportunities on coverage and liability.
- Anticipates and identifies transfer of risk, tender and/or indemnification.
- Directly handles and/or assists in monitoring, reviewing, and coordinating the activities involving commercial and/or personal lines insurance claims, including analysis of coverage issues, establishment of adequate reserves, and the resolution and closure of claims.
- Reviews loss notices; confirms and interprets policy coverages; establishes adequate reserves; and investigates and handles claims involving primary, umbrella, and/or excess policies.
- Manages litigation with Preferred Counsel under Alternative Fee Arrangements or other defense fee structures.
- Pursues and maximizes all risk transfer opportunities by contract or by insurance policy language.
- Assigns and manages work of defense counsel, assignment of expert witnesses and interfacing with peer carriers including design and execution of defense and indemnity contracts, evaluation of liability and damages and participation in settlement negations.
- Ensures proper file setup, reserving, general handling, and application of company procedure.
- Participates in developing claims handling strategies, including defense coordination, litigation strategy, motion practice, and budgets, and expense control.
- Records specific claims information and reports as appropriate to a manager relative to pertinent financial and general statistical records.
- Maintains diary control, investigates, analyzes, and reports to ensure maintenance of proper reserves to reflect the company’s exposure and reports to our Reinsurance Department to assist in providing notice to reinsurers and the Reinsurance Department’s recovery of specific amounts when payment exceeds the company’s retention.
- Handles large volume of diverse and dynamic claims effectively.
- Assists in Due Diligence inquiries as assigned.
Required Experience : Minimum of seven (7) years of commercial, business, and high value homeowners claims handling experience or a related field.
Required Education
Four-year college degree required or equivalent work experience.
Preferred Education or Certification
CPCU, SCLA, CCLA, state(s) adjuster license – NEW YORK LICENSE REQUIRED
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