Senior Large Loss and Litigation Adjuster

Job Description

Job Description

Description:

JOB SUMMARY: The Senior Large Loss and Litigation Adjuster is responsible for managing, investigating, and resolving high-value bodily injury claims which may include complex coverage issues, including those involving extra contractual handling. This role entails evaluating complex claims, overseeing litigated matters through verdict, conducting thorough investigations, negotiating settlements, and ensuring compliance with regulatory requirements. Responsible for maintaining relationships with litigation partners and defense counsel for handling litigated claims. The Senior Adjuster will also mentor junior adjusters and contribute to claims strategy and best practices.

DUTIES AND RESPONSIBILITIES:

• Evaluate and manage bodily injury claims from initial reporting to resolution including litigation, ensuring compliance with company policies and legal requirements.
• Conduct thorough investigations to assess the nature and extent of injuries, gathering relevant documentation and evidence.
• Assess and manage extra-contractual claims, ensuring proper documentation and adherence to legal and regulatory standards.
• Collaborate with medical professionals, legal teams, and clients to develop a comprehensive understanding of each case.
• Keep policyholders informed throughout the claims process, providing regular updates and addressing any questions or concerns they may have.
• Negotiate settlements with claimants and their representatives in accordance with company policies and regulatory requirements, striving for fair and equitable outcomes.
• Prepare detailed reports and documentation to support claim evaluations and settlement negotiations.
• Monitor case developments and provide updates to management and stakeholders as necessary.
• Collaborate with internal parties, legal counsel, and management, to resolve complex claims and mitigate risk.
• Maintain accurate and detailed claim files, documentation, and activity logs in accordance with company standards and industry best practices.
• Stay current with industry trends, regulations, and best practices in bodily injury claims management.
• Train and mentor junior staff on claims handling processes and strategies.

QUALIFICATIONS AND SKILLS:

• A bachelor's degree or comparable insurance experience.
• A minimum of 10 years of experience in bodily injury claims adjusting, including extra-contractual claims.
• Extensive litigation and legal knowledge.
• Strong knowledge of insurance principles, policies, and procedures.
• Enhanced knowledge of medical terminology, anatomy, and injury assessment.
• Excellent analytical and decision-making skills with the ability to assess complex issues and negotiate fair settlements.
• Proven negotiation and communication skills, with a track record of successful settlements.
• Ability to analyze complex information and make sound decisions.
• Proficiency in claims management software and Microsoft Office Suite.

WORKING CONDITIONS:

• This is an exempt position which complies with alternative work schedule when applicable.
• This position may require mandatory overtime as deemed appropriate by management.
• This work environment is fast-paced, and accuracy is essential to successful task completion.
• This office is that of a highly technical company supporting a paperless environment.
• Travel may be required.
• Vision abilities to work at close range and with small print.
• Physical efforts requirements include, but may not be limited to, repetitive small motor activity; grasping, ability to sit for an extended period of time; up to 8 hours per day, verbally communicating detailed and important information to others quickly and accurately, stooping, reaching, standing, lifting light objects under 10 pounds frequently and climbing occasionally (small step ladder to reach supplies).