Job Description
Engle Martin and Associates (a division of Cor Partners)is a leading national independent loss adjusting and claims management provider. We provide a comprehensive line of service offerings including commercial property casualty inland marine/cargo heavy equipment and large loss adjusting as well as TPA/claims management and subrogation.
The Senior Casualty/Property Liability Adjuster manages all aspects of liability claims in a variety of business classes effectively determining and communicating the extent of liability or damage associated with each claim. The adjuster assists the client in fulfilling its obligation to policyholders and maintaining the clients claims processing functions including; evaluating potential coverage issues liability and damages risk transfer opportunities litigation and settlement matters within the limits of assigned authority levels and in compliance with applicable legal and regulatory requirements. The claims assigned are based on the adjusters experience and demonstrated aptitude for handling large or complex matters with minimal supervision.
PRIMARY JOB RESPONSIBILITIES:
- Determines appropriate methods and extent of needed investigation for all assigned claims including conducting investigations through field visits and phone contact; obtaining contracts job files and appraisals; conducting insured witness and claimant interviews and/or statements complete site inspections; scope measure and write estimates and using other factfinding methods to evaluate liability damages and proper coverage.
- Uses knowledge of property and construction and/or knowledge of the specific industry or business affected personally conduct property inspections and photograph claim sites as necessary to depict and substantiate losses or damage or the lack thereof.
- Investigates insurance claims in a variety of settings including but not limited to: retail establishments office buildings residences condominiums apartments hotels corporate facilities governmental facilities schools clinics or hospitals; assess loss or damage resulting from various events including but not limited to inclement or catastrophic weather construction defect and fire.
- Conducts thorough interviews or other methods to obtain necessary information from the claimant and experts such as architects engineers builders construction workers police officers health care practitioners accountants and others to fully and accurately assess the extent of the loss.
- Applies a thorough understanding of insurance policies and policy interpretation to properly conduct an investigation establish appropriate loss estimates based on all relevant information and findings provide coverage recommendations and draft coverage letters if requested by the client.
- Applies an intermediate level of understanding of insurance policies and policy interpretation to properly conduct an investigation provide coverage recommendations and draft coverage letters if requested by the client with minimal supervision.
- Works cooperatively with expert witnesses attorneys underwriting department staff investigators vendors and carriers examiners as needed to conduct investigations confirm findings and support evaluations.
- Ensures the accuracy of the information collected and reported and guards against fraudulent claims based on critical issues identified and accurate conclusions drawn.
- Follows all applicable policies procedures and practices and incorporates sound judgment in formulating recommendations and completing evaluations and reports.
- Effectively use software systems such as Xactimate as necessary to produce accurate estimates.
- Prepares accurate clear thorough and concise reports and letters to insurance carriers providing appropriate conclusions and recommendations.
- Arranges contractors estimates and other specialists appointments as Attends trials arbitration ADR and facetoface negotiations as required.
- May be called upon to handle more complex claims involving various situations including contractor liability products liability and construction defects with the appropriate level of guidance.
- Ability to identify claims whose complexity warrants escalation to a more senior level adjuster.
- Identifies and addresses third party liability and tender opportunities through investigation and/or contract interpretation.
- Maintains accurate thorough field notes journal entries and time and expense records as Submits reimbursement reports in keeping with organization and client policies procedures and practices and within accepted industry standards.
- Applies knowledge of both timeandexpense and feeforservice procedures according to the stipulations of the agreement with the client.
Requirements:
- Baccalaureate degree in a related field or demonstration of equivalent experience with five 5 plus years experience in related claims handling preferred.
- Active license or ability to promptly obtain such in multiple jurisdictions.
- Fundamental understanding of claims adjudication knowledge of commercial and residential construction industries and/or basic knowledge of automotive and transportation industry desirable.
- Basic knowledge of casualty claims law and jurisdictional issues.
- Fundamental understanding of how to perform code investigations.
- Fundamental knowledge of estimate building through Xactimate.
- Understanding of the Commercial General Liability Policy Form.
- Sound negotiating conflict resolution and persuasion abilities.
- Ability to draft coverage letters with some supervision.
- Research and investigative abilities have been demonstrated at an Intermediate level.
- Ability to interpret written technical information.
- Proficient written and oral communication skills.
- Time management and organizational skills.