Commercial Large Loss Adjuster, Casualty

Department:

Job Description:

As the Large Loss Casualty Adjuster you will be responsible for investigating evaluating and settling first and third-party bodily injury and liability claims. The majority of the claims you will handle will involve Large Losses Construction Defect NY Labor Law Sexual Misconduct Environmental Trucking E&S and Professional Liability.

You will generally have settlement authority up to $175000 for liability claims. Supervisor direction should only be required for high-valued unique or multi-faceted claims over settlement authority.
You will work out of your home office and require limited supervision. To be successful in this position you must be familiar with complex claims concepts practices and procedures; possess creativity and latitude and excellent communication and presentation skills. You will rely on experience and judgment to plan and accomplish complex goals.

Work Arrangement:

• Employees who live within 30 miles of the TMG home office are expected to follow a hybrid or in-office schedule. The initial training period may require additional inoffice days.

Accountabilities:

• Handles claims ranging from moderate to complex with considerable latitude for action and decision.

• Makes coverage recommendations and total claim value determinations.

• Investigates coverage and cause of loss on routine to complicated claims which includes but is not limited to policy review evaluating current and prior medical history/problems. Interviewing all parties associated with the loss and gathering and analyzing all necessary investigative documentation.

• Reviews evaluates and negotiates bodily injury claims with unrepresented and represented insureds/claimants including litigation management. Evaluating injury claims and property damage claims will be primary focus. Review medical records and bills to validate accuracy of services provided. Completes bodily injury evaluation summary including liability damages causation diagnosis treatment reserves and general damages.

• Provides accurate assessments and negotiates fair and efficient claims resolutions while managing costs. Settles losses according to the documented damage the language of the policy of insurance pertinent regulatory and statutory considerations and within granted authority.

• Prepares written communication including but not limited to settlement letters disclaimers of coverage and reservation of rights letters

• Maintains effective claim file documentation and diary system. Monitor diary to achieve timely development of file and timely disposition of the claim

• Recognizes and prepares submissions to SIU when indicated.

• Assigns and supervises vendor resources including but not limited to independent adjusters engineers and other experts as needed

• Helps to identify problems that affect team effectiveness or efficiency and recommend changes in procedures.

• Travels and attends mediations or training as needed.

Qualifications:

• Bachelors degree preferred

• Professional designations are preferred

• 10 years in the handling of Claims.

• Understands concepts of coverage policy interpretation exposure recognition and liability determination.

• State licensing or certification where required.

• Ability to take responsibility and work independently in a home-based environment.

• Strong communication and analytical skills.

• Ability to negotiate skillfully in difficult situations.

• Must have strong organizational and time management skills.

• Ability to formulate sound expense indemnity and business judgment while supporting loss evaluations and presenting them effectively.

• Basic computer skills including Microsoft applications Word Excel Outlook and the Internet.

• Perform work related simple and advanced mathematical problems and calculations.

• Compose written correspondence and factual reports which are well-organized and concise utilizing proper English grammar punctuation and spelling.

• Demonstrates the ability to use commonly-used claims concepts practices and procedures.

• Must meet or exceed the ability to demonstrate the 5 core and common competencies outlined below.

• Convey clear concise information to others using verbal or other appropriate communication techniques.

• Complete formal training plan and assignments as required.

• Follow safe practices in all work activities to avoid injuries and accidents.

Benefits:

We are proud to offer our full-time regular employees a robust benefits suite that includes:

• Competitive base salary plus incentive plans for eligible team members

• 401(K) retirement plan that includes a company match of up to 6% of your eligible salary

• Free basic life and AD&D long-term disability and short-term disability insurance

• Medical dental and vision plans to meet your unique healthcare needs

• Wellness incentives

• Generous time off program that includes personal holiday and volunteer paid time off

• Flexible work schedules and hybrid/remote options for eligible positions

• Educational assistance

Equal Opportunity Employer

The Mutual Groupis an Equal Opportunity Employer. It is our policy to recruit hire train and promote individuals in all job classifications without regard to race color religion sex national origin age veteran status disability sexual orientation gender identity or any other characteristic protected by law.

• Know Your Rights: Workplace Discrimination is Illegal

• Your Rights Under USERRA

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact.

Employment Verification

The Mutual Group participates in theE-Verifyprogram and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. You are protected fromemployment discriminationbased on your citizenship status and national origin.

E-Verify Program Overview

E-Verify Participation Poster

All offers of employment are contingent upon the successful completion of a background check.

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