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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 on going 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:
Examiners are responsible for confirming coverage by reviewing the first notice of loss and policy information. Examiners prepare coverage position letters such as disclaimers and reservation of rights. Once coverage is confirmed, the examiner conducts a thorough and focused investigation of the claim to assess liability and damages. Examiners must understand and apply statutory and case law to assess liability exposure. Examiners should identify joint tortfeasors and ensure all parties pay their fair share. Examiners are responsible for maintaining adequate reserves as the claim develops to properly reflect ultimate exposure based upon liability and damage evaluation. Examiners are responsible for proactive file management toward final disposition via an effective diary, directly negotiating claims with a claimant or claimant attorney, overseeing defense counsel to ensure effective litigation management with established guidelines and reviewing/approving settlement agreements. Examiners must maintain substantive file notes that document all relevant claim activity. Examiners are responsible for preparing comprehensive and concise reserve authority requests, reinsurance reports, serious loss reports, coverage position letters as well as reports to underwriting and other departments.
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:
Understanding of legal concepts, litigation processes and agency filings. Strong oral and written communication skills, insightful analytical skills, effective negotiation skills, strong organizational and time management skills, technical knowledge of insurance coverage, employment law and claim evaluation.
Minimum Job Requirements:
At USLI, our goal is to strengthen our community and culture by representing all races, genders, religions and sexual orientations. We continue to move conversations about diversity, equity and inclusion forward to ensure every community member has a sense of belonging, a voice and a seat at the table.
USLI provides full-time community members with a comprehensive benefits package, access to wellness programs, continuing education resources, and multiple opportunities to get involved with charitable organizations.
