This position requires a claims professional with technical excellence and the ability to handle large-loss and/or catastrophic loss property, habitability, and environmental claims. The General Adjuster is expected to provide the highest level of customer service and benefit provision along with the superior technical claim-handling skills to address sophisticated and complex risks that include investigation, evaluation, and negotiations. The General Adjuster serves an important role in the management of the relationship that the Company has with the claimant and the insured. This position requires frequent travel and on-site inspections and investigations of loss and must work effectively in a remote work environment.
- Monitors and supervises the most complex Property claims in the Company. Investigates at the loss site. Evaluates the loss, coverage, construction costs, construction techniques, local building codes and ordinances. Determines cause and origin including third party exposure. Identifies questionable or inconsistent information. Submits concerns to Home Office Claim Management.
- The position requires documentation of claim files accurately, thoroughly, and compose reports, and correspondence to track and report on the status of individual claims in compliance with reinsurance needs and State DOI regulations. The individual is required to maintain an effective diary system to track claim status, enter and retrieve data on a claims management processing system, and authorize the issuance benefit payments. Other key duties are the identification recovery opportunities, salvage issues and loss exposures. In the event of fraud or acts of arson, the General Adjuster will report findings to SIU for investigation and reporting.
- Settles claims within the scope of the Company’s contractual and legal obligations to ensure that settlements are fair and equitable to the insured, the claimant, and the Company. Determines the extent of damage, formulates and communicates settlement offers based on evaluation of liability and coverages. Reviews price lists to determine repair/replacement costs. Negotiates offers with insureds and their legal representatives in a timely manner. Issues all payments promptly upon receipt of sufficient documentation.
- The GA establishes and monitors claims and reserves, to accurately reflect CIG’s liability for outstanding losses. Reviews reserves periodically to evaluate based on new evidence or developments in the life of a claim. Reports findings on reserve issues and damages as needed to our reinsurers.
- Communicates with Home Office and Regional Claim Managers, insureds, agents, experts, and others associated with an individual claim, in writing, orally and face-to-face. Communicates with Underwriting and Loss Control when deficiencies are noted involving the insured risk. Determines when additional resources are needed beyond the scope of the incumbent’s position or individual capabilities and communicates needs to the Home Office Claim Management. Assists defense attorneys in discovery process.
- May be required to train assigned staff and/or complete special projects at the direction of Home Office Claim Manager or the Vice President of Claims. Conducts re-inspections of independent adjusters and staff.
- This position requires someone who can be readily available to travel within very short notice to the far ends of corporate territory. Weekly overnight travel is often required. The incumbent monitors, directs, and participates in complex, high-value claim files requiring immediate emergency response. Scope of Property construction estimates will range from $125,000 to $2 million.
- In-depth technical knowledge of Property coverage
- Applicable insurance regulation codes and building codes in Corporate Territory
- Current claims laws, specifically civil and tort law and current trends in Property insurance case law and issues
- Building construction terminology
- Negotiation techniques and practices/procedures for handling complex Property claim files.
- English to be able to proficiently communicate complex issues orally and in writing
- Strong working knowledge of mathematics along with common accounting practices that pertain to Business Income and Extra Expense claims.
- Work independently with minimum supervision.
- Take charge and provide direction and set parameters to all involved
- Come up with own creative solutions to resolve issues.
- Effectively manage limited time and resources.
- Publish and write technical reports on coverage, determination of loss, cause and origin, future handling recommendations to clients and experts as necessary.
- Demonstrate advanced analytical skills in the identification and examination of a multitude of elements, both factual and ambiguous in nature, in a highly complex case
- Plan, organize, and prioritize work under the pressure of critical deadlines
- Perform inspections of sites and properties, including roofs, basements, and attics, which may require the use of ladders or stairs to access or the ability to kneel, crawl, and bend
- Demonstrate strong negotiation skills and communicate complex legal concepts and policy-contract interpretation in writing and orally
- Read and comprehend complex contracts, technical journals and articles pertaining to insurance claims laws, regulations and value loss and damage
- Establish effective work relationships with those contacted in the course of the work
- Obtain and maintain a valid California Driver License and operate a vehicle
- Travel requirements will include weekly multiple overnight stays
Education and Experience
College degree or equivalent experience along with seven to ten years of progressively challenging claim adjusting that includes a minimum of three years of experience in handling complex Property files. This individual must be technically sound and have field experience adjusting catastrophe claims. A commitment to continuing education is required along with advanced technical training in insurance claims such as Vale Tech or equivalent. Property Claims Law Associate designation is preferred and AIC is recommended.
- Competitive Compensation
- Employee Stock Ownership Plan
- Generous Paid Time Off
- Career Growth
- Life Insurance
- Established and well respected company
CIG’s main office is located in beautiful Monterey, CA.
Learn more about us by visiting ciginsurance.com.
Learn more about our benefits here.
Capital Insurance Group is an equal opportunity employer committed to a diverse workforce. EEO/M/F/V/H