Complex Claims Analyst, P&C

Job Description

Job Description

Reporting to the Unit Manager, this role will be responsible for direct handling of multi-line commercial claims including Auto, General Liability and Construction Defect claims. Duties include investigation and evaluation of coverage, liability and damages issues. The role will be responsible for claim evaluation, establishment/recommendation of adequate reserves, litigation management, case resolution and transaction processing in alignment with the Company’s and Client’s Strategic Vision.

Essential Functions

• Directly handles and/or assists in monitoring, reviewing, and coordinating the activities involving multi-line commercial 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 excess policies.
• Ensures proper file setup, reserving, general handling and application of company procedure.
• 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.
• Participates in developing claims handling strategy, including defense coordination, litigation strategy 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.
• Empowered to make decisions within job description and authority. Seeks guidance where appropriate.
• Develops creative ideas and solutions to real time business problems and /or business opportunities; Takes reasonable, calculated risks even if failure is possible.
• Seeks continuous development by identifying areas for growth improvement and works with team to implement process and technical improvements
• Empowers self and teammates to continuously improve Company’s business processes/systems and develops and escalates ideas and solutions.
• Understands Key Performance Indicators and works towards those priorities.
• Consistently delivers superior customer service to both internal and external business partners.
• Performs special projects and assignments related to area of authority as necessary.
• Maintains confidentiality.
• Establishes and maintains professional relationships.
• Assists in Due Diligence inquiries as assigned.
• Travels as required.
• Obtains and maintains claims adjuster licenses in those states requiring them.

Organizational

• Demonstrates alignment with Company’s Commitments.
• Prioritizes and organizes work in self-directed manner.
• Attains and maintains knowledge of assigned department.
• Performs other duties as required, including supporting and coordinating with other department colleagues.

Related Functions:

• Serves on Companywide committees and projects as assigned.

Required Skills

• Strong analytical, interpersonal and communications skills, written and verbal, required.
• Capable of working independently and meeting assigned deadlines.
• Customer service oriented with the ability for developing long lasting relationships with internal and external business partners.

Experience

Minimum of 2+ years’ experience in claims or related field.

Required Education

Four-year college degree or equivalent work experience.