Liability Claims Examiner

Partnership Employment; Methuen (MA); On-site; USD 70,000 - 110,000; Full time

Job summary

Partnership Employment in the United States seeks an experienced Liability Claims Examiner to oversee all stages of liability claims for homeowners, landlord, businessowners, and umbrella policies. The role emphasizes claim strategy, oversight of investigations, and coordination with outside counsel, with New York claims experience strongly preferred.

The Examiner will direct investigations, determine coverage and reserves, and manage settlements and litigation Strategy, while field adjusters

Qualifications

• Minimum 5 years of liability claims handling experience.
• Experience managing litigated liability claims strongly preferred.
• State-specific Adjuster License as required.
• Experience working with outside defense counsel preferred.

Responsibilities

• Evaluate and confirm insurance policy coverage for liability claims.
• Direct and oversee claim investigations conducted by Independent Adjusters and other professionals.
• Analyze liability, damages, coverage issues, and potential exposure to determine appropriate claim strategy.
• Manage claims from initial investigation through resolution, including both litigated and non-litigated matters.
• Assign and oversee Independent Adjusters, defense counsel, experts, and other outside resources as needed.
• Manage litigated claims and maintain ongoing oversight of outside defense counsel.
• Monitor defense counsel’s strategy, progress, recommendations, and legal expenses.
• Evaluate litigation exposure and make appropriate recommendations regarding claim resolution.
• Establish, review, and modify claim reserves based on the development of the claim.
• Maintain timely claim diaries and ensure appropriate follow-up and documentation.
• Lead claim negotiations and settlement discussions and authorize payment and settlement requests within applicable authority.
• Manage adjustment and litigation expenses.
• Ensure claims are handled in accordance with applicable state regulations, insurance laws, administrative requirements, and company guidelines.
• Attend mediations, trials, depositions, and other legal proceedings as required.
• Analyze and respond to consumer complaints and insurance department inquiries.
• Collaborate on special Claims Department and company-wide projects.
• Assist other Claims Examiners during catastrophes, vacations, medical leave, or periods of increased workload.
• Maintain current knowledge of liability claims practices, insurance regulations, litigation trends, and applicable state requirements.
• Effectively manage a high-volume caseload while maintaining timely claim handling and quality service.
• Utilize claims management systems and other technology to document, track, and manage claims.

Skills

Analytical skills

Negotiation

Decision making

Communication skills

Time management

Independent work

Collaboration

Customer service focus

Education

State-specific Adjuster License

Tools

Claims management systems

Job description

We are seeking an experienced Liability Claims Examiner to manage and evaluate liability claims arising from homeowners, landlord, businessowners, and umbrella insurance policies. This position is responsible for overseeing all phases of the claims process, including investigation, coverage determination, damage evaluation, negotiation, settlement, and litigation.

The Claims Examiner will primarily focus on claim oversight, technical analysis, decision-making, litigation management, and coordination rather than personally performing field adjusting. Independent Adjusters are utilized for field investigations, while the Examiner maintains responsibility for evaluating the claim, directing the investigation, making coverage and reserve decisions, and managing the overall claim strategy.

New York claims experience is strongly preferred, particularly experience handling litigated claims and working with outside defense counsel. New York claims can involve a significant level of litigation and state-specific requirements, so candidates should be comfortable monitoring counsel, evaluating litigation strategy and progress, and maintaining appropriate oversight and quality control.

Key Responsibilities

• Evaluate and confirm insurance policy coverage for liability claims.
• Direct and oversee claim investigations conducted by Independent Adjusters and other professionals.
• Analyze liability, damages, coverage issues, and potential exposure to determine appropriate claim strategy.
• Manage claims from initial investigation through resolution, including both litigated and non-litigated matters.
• Assign and oversee Independent Adjusters, defense counsel, experts, and other outside resources as needed.
• Manage litigated claims and maintain ongoing oversight of outside defense counsel.
• Monitor defense counsel’s strategy, progress, recommendations, and legal expenses.
• Evaluate litigation exposure and make appropriate recommendations regarding claim resolution.
• Establish, review, and modify claim reserves based on the development of the claim.
• Maintain timely claim diaries and ensure appropriate follow-up and documentation.
• Lead claim negotiations and settlement discussions and authorize payment and settlement requests within applicable authority.
• Manage adjustment and litigation expenses.
• Ensure claims are handled in accordance with applicable state regulations, insurance laws, administrative requirements, and company guidelines.
• Attend mediations, trials, depositions, and other legal proceedings as required.
• Analyze and respond to consumer complaints and insurance department inquiries.
• Collaborate on special Claims Department and company-wide projects.
• Assist other Claims Examiners during catastrophes, vacations, medical leave, or periods of increased workload.
• Maintain current knowledge of liability claims practices, insurance regulations, litigation trends, and applicable state requirements.
• Effectively manage a high-volume caseload while maintaining timely claim handling and quality service.
• Utilize claims management systems and other technology to document, track, and manage claims.

Businessowners policies represent a significant portion of the overall claims book.

The overall claims portfolio includes both litigated and non-litigated matters. Candidates should be comfortable managing claims throughout the litigation process when attorneys become involved.

Litigation Experience

Litigation experience is an important component of this position. The ideal candidate will have experience managing claims after litigation begins and working effectively with outside defense attorneys.

Candidates do not need to be attorneys but should be able to:

• Evaluate counsel’s strategy and recommendations.
• Track litigation progress and important deadlines.
• Assess liability and litigation exposure.
• Review legal expenses and manage litigation costs.
• Maintain appropriate oversight and quality control.
• Make informed decisions regarding settlement and claim resolution.
• Strong technical knowledge of liability claims handling.
• Experience managing liability claims through resolution, including litigated claims.
• Knowledge of insurance policy coverages, regulations, and legal theories related to liability claims.
• Experience working with outside defense counsel and other claims professionals.
• Strong analytical, negotiation, and decision-making skills.
• Excellent verbal and written communication skills.
• Strong organizational and time management abilities.
• Ability to manage a high-volume caseload and competing priorities.
• High level of integrity and professionalism.
• Strong customer and service orientation.
• Ability to work independently and collaborate effectively with internal and external partners.
• Comfortable learning and working within claims management systems and other technology.

Education & Experience

• Minimum of 5 years of liability claims handling experience.
• Experience managing litigated liability claims strongly preferred.
• Experience working with outside defense counsel preferred.
• State-specific Adjuster License as required.

Key Performance Areas

• Timely and effective claim resolution.
• Accurate coverage, liability, and damage analysis.
• Effective management of litigated and non-litigated claims.
• Quality oversight of Independent Adjusters, defense counsel, and other outside resources.
• Appropriate management of reserves, settlements, and claim expenses.
• Compliance with applicable regulations and company procedures.
• Quality service to policyholders, agents, and other stakeholders.
• Effective use of claims management technology.