Claims Examiner Personal Lines

USLI; Oak Brook (IL); Hybrid; USD 65,000 - 95,000; Full time

Benefits offered by this job

Performance-based triannual bonuses

Medical benefits paid at 100% for full-time employees

Profit-sharing program

Free lunch every day while onsite

Access to more than 450 annual personal and professional development courses

Job summary

USLI is seeking a Claims Examiner to evaluate coverage, investigate claims, and collaborate with various teams. The ideal candidate has strong negotiation skills and a background in claims handling.

This role includes remote work options, competitive pay ($65K - $115K based on experience), and comprehensive benefits such as performance bonuses, full medical coverage for full-time employees, and access to numerous professional development courses.

Qualifications

• 2+ years of relevant experience for Associate Claims Examiner.
• 7+ years of relevant experience for Claims Examiner.
• Previous experience as an examiner, adjuster, paralegal, attorney, or in other transferable roles.
• Experience in personal lines claims handling is preferred.
• Multi‑jurisdictional experience and advanced degrees or JD are a plus.

Responsibilities

• Confirm coverage by reviewing loss notices and policy details.
• Conduct detailed investigations into claims.
• Retain and provide directions to independent adjusters.
• Evaluate liability exposure based on statutory and case law.
• Maintain accurate reserves reflecting liability and damages.
• Proactively manage claim files and negotiate settlements.
• Prepare comprehensive reserve authority requests and reports.
• Collaborate with underwriting and compliance teams.

Skills

Problem‑solving skills

Communication

Negotiation expertise

Organization

Technical knowledge

Job description

Your Role

You’ll play a critical role in evaluating coverage, liability, and damages for each unique claim. You’ll collaborate across teams and with external stakeholders to effectively investigate, negotiate, and resolve claims.

Key Responsibilities

• Coverage review: Confirm coverage by reviewing the first notice of loss and policy details; prepare DISCLAIMERS and reservation of rights letters as necessary.
• Thorough investigation: Conduct detailed investigations into claims, including liability and damages assessment, witness interviews, scene inspections, and evidence collection.
• Independent adjusters: Retain and provide directions to independent adjusters while managing all aspects of the investigation process.
• Liability analysis: Apply statutory and case law to evaluate liability exposure and ensure joint tortfeasors contribute their fair share.
• Reserve maintenance: Maintain accurate reserves reflecting liability and damages as claims develop.
• File management: Proactively manage claim files, negotiate settlements directly with claimants or attorneys, oversee defense counsel, and ensure effective litigation management.
• Reporting: Prepare comprehensive reserve authority requests, reinsurance reports, serious loss reports, and coverage position letters.
• Cross-team collaboration: Provide updates and collaborate with underwriting, compliance, and actuarial teams to maintain healthy products.

What You’ll Bring

• Problem‑solving skills: Analytical and creative problem‑solving capabilities with a focus on liability and damage evaluation.
• Communication: Strong oral and written communication skills to effectively interact with all stakeholders.
• Negotiation expertise: Assertive decision‑making with effective negotiation and conflict management skills.
• Organization: Strong organizational and time management skills to manage multiple priorities efficiently.
• Technical knowledge: Familiarity with insurance coverage, negligence law, and claim evaluation processes.

Qualifications

• 2+ years of relevant experience for Associate Claims Examiner.
• 7+ years of relevant experience for Claims Examiner.
• Previous experience as an examiner, adjuster, paralegal, attorney, or in other transferable roles.
• Personal lines experience: Experience in personal lines claims handling is preferred.
• Liability and jurisdiction knowledge: Multi‑jurisdictional experience and advanced degrees or JD are a plus.

Work Arrangements

Position affords 5 days per month to work remotely.

Salary Range

Associate Claims Examiner: $65K - $95K; Claims Examiner: $85K - $115K

Benefits

Competitive salary and benefits program for full‑time and eligible part‑time employees. Benefits include performance‑based triannual bonuses, medical benefits paid at 100% for full‑time employees and 80% for eligible part‑time employees, a profit‑sharing program, free lunch every day while onsite, and more than 450 annual personal and professional development courses.