Claims Examiner- Property & Liability (Building Inspector)

92128, San Diego

 

PURPOSE OF THE JOB

The purpose of this job is to fulfill the insurance promise through the adjusting of property and/or liability claims in a professional and cost-effective manner. This position encompasses handling primarily smaller to medium complexity and exposure claims and performing building inspections as needed. This position exists to reserve, manage, and bring claims to an equitable conclusion within the Company standards and best practices guidelines.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Applies technical knowledge skills to ensure fair and prompt management of cases.

  • Oversees all aspects of claims assigned. Assignments will be primarily, but not limited to less serious to moderate exposure claims.
  • Communicates with insureds to obtain information necessary for processing claims.
  • Determines coverage on all cases assigned. Issues coverage letters timely as appropriate for management approval.
  • Establishes preliminary reserves within 3-7 days and regularly reviews them for accuracy.
  • Negotiates settlements.
  • Reviews all files assigned and takes appropriate interim action to move the claim to resolution using a regular diary system.

Investigates and gathers necessary information in order to settle assigned claims.

  • Conducts timely and thorough investigations of claims and makes assignments to independent adjusters, where appropriate.
  • Investigates claims and makes liability decisions within appropriate Division of Insurance (DOI) guidelines, or issues letter requesting additional time if appropriate based on continuing investigation.
  • Alerts underwriters to pertinent issues.
  • Creates and adjusts reserves in a timely manner to ensure reserving activities are consistent with company policies.

Assists in operational duties for the P/C Claims department.

  • Adheres to Fair Claims Settlement Practices and Department of Insurance Regulations and time frames.
  • Manages reinsurance recognition, reporting, and ceding.
  • Handles claims in diverse jurisdictions and states as needed.
  • Communicates effectively with other Company departments.
  • Maintains a good working relationship with insureds, independent adjusters, and other employees.

Conducts building inspections as assigned.

  • Schedules and coordinates building inspection schedules based on assignments from underwriters throughout assigned territory.
  • Conducts building inspections and completes inspection report utilizing assigned software.
  • Submits reports timely based on statutory deadlines.
  • Provides additional advice to underwriters as necessary based on inspections, including any preexisting damages noted.

SUPERVISORY RESPONSIBILITIES

This position has no supervisory responsibility.

EDUCATION AND EXPERIENCE

Bachelor's degree from four-year college or university preferred.

Minimum 1-3 years of related claims experience, or equivalent combination of education and experience.

CERTIFICATES, LICENSES, REGISTRATIONS

Current driver's license required.

Various state adjuster licenses and earthquake adjuster certification may be required. Licenses and certifications may be acquired within a specified timeframe after hire.

KNOWLEDGE AND SKILLS

Excellent verbal communication skills, time management, and organizational skills. Requires a high level of attention to detail. Ability to read, analyze, and interpret general business periodicals. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs. Ability to define problems, collect data, establish facts, and draw valid conclusions.

PHYSICAL REQUIREMENTS

Office environment – no specific or unusual physical or environmental demands and employees are regularly required to sit, walk, stand, talk, and hear. Extended standing and/or walking and climbing ladders may be required at building inspection sites. Travel required to building inspection sites.

COMPETENCIES

This position maps to the Individual Contributor level. Additional competencies required: None.

WORK ENVIRONMENT

This position operates in an office environment and requires the frequent use of a computer, telephone, copier, and other standard office equipment. Building inspection site requirements may result in exposure to dust and debris and may vary in the environment at each site. The noise level in the work environment at building inspection sites may be moderate to loud.

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