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Associate Claims Examiner-Professional
Location:Wayne, PA
Job Type:Claims
FT/PT Status:Full Time
Job Description

The ideal claims team member will be an analytical and creative problem solver with the ability to hone in on key issues for coverage, liability and damage evaluation. Our claim examiners are assertive decision makers with a strong desire to persuade through negotiation and conflict management. The claims team offers ongoing challenges, even for the most experienced professional, as every claim is unique, providing new opportunities to learn and grow. We welcome our ongoing interaction with underwriting, compliance and actuarial to keep our products healthy.

Essential Functions:

Coverage is confirmed by reviewing the first notice of loss, checking all available systems, and interpreting policy language.   Upon coverage analysis, the examiner prepares initial position letters to the policyholder such as disclaimers and reservation of rights. Once coverage is confirmed, the examiner conducts a thorough and focused investigation of the claim. Investigation includes securing all pertinent facts, statements & documents, identifying joint tortfeasors and witnesses as well as scene investigation. Initial reserves are posted, reviewed and maintained as file develops to properly reflect ultimate exposure based upon liability and damage evaluation. The examiner is responsible for proactive file management toward final disposition via an effective diary, direction to defense counsel & independent adjusters, analysis & strategy leading to negotiated settlement or trial. Substantive file documentation in claim notes should reflect file activity. While the claim is pending, communication includes delivery of comprehensive and concise authority requests, reinsurance reports, serious loss reports, coverage position letters and appropriate communication with underwriting and actuary.

 Other Duties and Responsibilities:

In addition to the essential functions, an examiner is expected to support customer service by responding the same day to phone and email both internally and externally and adhere to established claim service promises.  The position may entail completion of special projects.  There is an expectation for enrollment in continuing education to maintain state licenses and to support both professional and personal development as outlined in the annual Individual Development Plan.  Occasional travel required i.e. attendance at mediation or court hearings.

Specific Skills:

Strong oral and written communication skills, insightful analytical skills, effective negotiation skills, strong organizational and time management skills, technical knowledge of insurance coverage, negligence law and claim evaluation.

Minimum Job Requirements:

3 to 7 years claim handling experience and/or comparative litigation experience. Experience with D&O, E&O claims and/or other professional claims involving claims-made policies is a plus.  Multi-jurisdictional knowledge, advanced degrees and/or JD are also a plus. CPCU, AEI, RPLU or INS preferred. State Licenses as appropriate.

In response to the COVID19 pandemic, USLI has chosen to work remotely (from home) until further notice. This includes training and onboarding for all new hires. All applicants must be able and willing to return to onsite employment in Wayne, PA once we decide to return to working from our physical offices.