Claims Examiner: Investigations, Coverage & Settlements

USLI; Pennsylvania; Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Performance-based bonuses

Medical benefits

Profit-sharing

Free lunch onsite

Job summary

USLI is seeking an experienced claims professional to evaluate coverage, liability, and damages for each unique claim. You will collaborate across teams and external stakeholders to investigate, negotiate, and resolve claims with a focus on accuracy and fairness.

The role involves reviewing coverage, conducting detailed investigations, and coordinating with independent adjusters, attorneys, and underwriters to ensure proper settlements and reserves.

Qualifications

• 2+ years of relevant experience for Associate Claims Examiner.
• 7+ years of relevant experience for Claims Examiner.
• Experience as an examiner, adjuster, paralegal, attorney, or in a related role.
• Specialized experience: Employment Practices, D&O, and/or E&O claims is highly preferred.
• Multi-jurisdictional knowledge, advanced degrees, and/or JD are a plus.

Responsibilities

• Review coverage by examining first notice of loss and policy details; prepare disclaimers and reservation of rights letters.
• Conduct thorough investigations into claims, including liability and damages assessment, witness interviews, scene inspections, and evidence collection.
• Retain and direct independent adjusters while managing all aspects of the investigation.
• Apply statutory and case law to evaluate liability exposure and ensure fair allocation among joint tortfeasors.
• Maintain accurate reserves reflecting evolving liability and damages.
• Proactively manage claim files, negotiate settlements with claimants or attorneys, oversee defense counsel, and manage litigation.
• Prepare reserve authority requests, reinsurance reports, serious loss reports, and coverage position letters.
• Provide updates and collaborate with underwriting, compliance, and actuarial teams.

Skills

Problem-solving

Communication

Negotiation

Organization

Technical knowledge

Education

JD or advanced degree

Tools

Job description

USLI is seeking an experienced claims professional to evaluate coverage, liability, and damages for each unique claim. You will collaborate across teams and external stakeholders to investigate, negotiate, and resolve claims with a focus on accuracy and fairness.

The role involves reviewing coverage, conducting detailed investigations, and coordinating with independent adjusters, attorneys, and underwriters to ensure proper settlements and reserves.