Claims Adjuster - Litigation - Disputed
Essential Functions and Responsibilities: The following are the usual, basic and essential functions of the position. These functions are not to be construed as an exhaustive list of all responsibilities, duties, and skills required.
Proactively investigate coverage, liability and damages with all parties involved in a claim. Review each claim for coverage issues, utilize coverage attorney opinions, and work with supervisors to resolve.
Review and evaluate new lawsuits to determine appropriate future strategy and stay abreast of legal trends and case law. Understand and apply state specific law and regulations in highly litigious venues in Florida and Texas to include the use of dispute resolution practices in an insurance contract such as Appraisal.
Review and interpret legal opinions and expert reports.
Assist other departments with policy and coverage questions
Review and analyze litigated claims on an ongoing basis and work with defense counsel to develop and control strategies, in consideration of all applicable laws, venues, while controlling costs and determining settlement value versus defense at Mediation, Appraisal, or trial. Consider appropriate use of mediation, appraisal or trial.
Refer lawsuits to properly approved defense attorneys, and direct their handling, including the authorization of discovery actions and motions practice
Document claim file notes clearly, with all communications and activities that occur during handling of the claim, using factual and objective information
Maintain a current diary on all open claims
Though primary duties are handled inside, attendance at trials, mediations and or depositions may be required.
Direct negotiation with attorneys on settlement of cases.
Other duties as assigned
This position requires an intense level of initiative, sense of ownership and the desire to achieve in an environment of increasing responsibility, opportunity and career development. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.
Specific Job Qualifications: (knowledge, skills, and abilities)
Bachelors degree or equivalent industry-related experience (work history with a record of advancement in property & casualty insurance claims); a blend of office and field assignments/experience preferred along with some catastrophe claims involvement
Minimum of five (5) or more years of claims adjusting/examining, handling moderate to complex claims in a homeowner’s driven personal lines insurance environment.
Knowledge of civil procedures in Florida or Texas.
Knowledge of the Mediation and Appraisal process in Florida andTexas
Knowledge and experience in teaming cross departmentally to influence claim outcomes
Must have the ability to collect, compile and organize facts, figures and/or other information in accordance with established company procedures, and can write/produce concise and accurate reports and proposals
As required by regulatory entities to include an applicable Florida and or Texas adjuster license and maintained in good standing.
Relevant professional designations and certifications highly desirable. (CPCU, AIC, SCLA, etc.)
Current Florida driver’s license and acceptable driving history is required. License must be valid at all times and maintained in good standing.