Liability Claims Examiner

Appone; Woodbury (NJ); Remote; USD 65,000 - 90,000; Full time

Job summary

Vanguard is hiring a Liability Claims Examiner to investigate and evaluate insurance claims, determine liability, and manage the claims process from inception through settlement. The role includes handling construction defect claims, engaging in mediation or arbitration as needed, and ensuring timely resolutions for clients.

The position emphasizes strong written and oral communication, adherence to SOC 2 security practices, and the ability to coordinate with insureds, claimants, and attorneys.

Qualifications

• Handles liability and construction defect claims from inception to completion.
• Performs complete liability, coverage and bodily injury investigations.
• Reads and interprets insurance policies and endorsements in context of claims.

Responsibilities

• Investigate and evaluate insurance claims to determine liability.
• Negotiate settlements up to authority limits.
• Prepare client reports with recommendations for disposition.

Skills

Liability claims handling

Litigation support

Communication skills

Investigations

Claims management

Education

High School Diploma or Equivalency

Insurance designations (AIC, CPCU) preferred

Tools

Claims Management Systems

Microsoft Office Suite

Job description

About the Organization Vanguard, founded in 1997 solely as an independent adjusting firm, today serves not only as an adjusting firm but third-party administrator and catastrophe claim unit. With growing influence in London, we increasingly became one of London's largest independent adjusting and TPA firm. We have handled first party property and casualty claims for both the domestic and London market for over 20 years and believe it is our superior investigative and reporting techniques delivered by our highly seasoned staff that sets us apart. It is our moto that EVERY CLAIM COUNTS.
If you are looking to become a part of our growing family company, driven by the latest technology and staffed with top talent, then we encourage you to apply with Vanguard today.

Position Liability Claims Examiner

Description

We currently have an opening for a Liability Claims Examiner. The role of Vanguard's Liability Examiner is to investigate and evaluate insurance claims, determining liability, handling construction defect and managing the claims process, often including litigation and settlement negotiations, to ensure timely and cost-effective resolutions for our clients.

Job Requirements

• Handling liability and construction defect claims from inception until completion; reviewing liability claims, litigated by counsel or insurance adjuster managed; maintaining a point person role reporting to the proper client and ensuring all time lines are properly followed; resolving claims by denial, settlement or referral to another insurance company.
• Performs complete liability, coverage and bodily injury investigations. Reviews and evaluates claim based on evidence obtained to determine responsible parties, liability exposure, questions of fraud or other pertinent issues.
• Claims in Construction Defects are often involved and require contract analysis, managing litigation/arbitration with numerous defendants and coverage issues that may involve multiple policy years, varied insurers and types of insurance coverage specific to the construction trades industry.
• Reads, analyzes and interprets insurance policies and endorsements, applicable state and local statutes, case law and applies to claim situations
• Orders bills and reports from medical providers of injured parties, obtain police/ambulance/fire reports, medical histories and ISO reports to determine facts and prior accident information
• Prepares and maintains file documentation, communicates with insureds, claimants or attorneys regarding progress of claim. Negotiate settlements of claims with insureds, claimants and others up to authority limits
• Draft reports to clients with recommendations for claim disposition
• Attend Mediations/Arbitrations/Trials as necessary
• Manage legal expenses, reserves and financial transactions
• SOC 2 Compliance Responsibilities
  • Handle all claimant, policyholder, client, and company information in accordance with SOC 2 security, confidentiality, and data integrity standards.
  • Ensure sensitive data is stored, transmitted, and processed securely, following company policies and procedures.
  • Maintain accuracy and completeness of information in all systems, reports, and documentation.
  • Promptly report any actual or suspected security incidents, policy violations, or data handling concerns to management.
  • Participate in training and awareness initiatives to stay current on SOC 2 requirements and best practices.
  • Support audit readiness by providing documentation, evidence, or explanations of compliance activities when requested.
• Performs additional responsibilities as needed to support business operations and compliance objectives.

Position Requirements

• A High School Diploma or Equivalency is required.
• At least 3-5 years’ experience in liability claims handling required.
• Property and Casualty Insurance policy knowledge; proficiency in writing and research; knowledge and understanding of Property/Casualty policies
• Understanding of insurance coverage issues; understanding of the workings of Underwriters at Lloyds of London; a basic understanding of tort law and state mandates standards of negligence standards
• Required State licenses (must obtain applicable state licenses)
• Strong written/oral communication and interpersonal skills.
• Ability to manage a pipeline of claims and have strong organizational skills.
• Proven ability to provide exceptional customer service.
• Computer skills with the ability to work with multi-faceted systems.
• Insurance designations (AIC, CPCU) preferred.
• The ability and willingness to assist other departments as company needs arise.
• Strong proficiency in Microsoft Office Suite and experience with Claims Management Systems.

Location Headquarters- Remote

EOE Statement Vanguard is committed to a diverse and inclusive workplace. Vanguard is an equal opportunity employer and does not discriminate on the basis of race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or any other legally protected status.

This position is currently accepting applications.