Senior Corp Claims Specialist - National Environment and Asbestos Experience

PMA Companies; Chicago (IL); Remote; USD 70,000 - 90,000; Full time

Job summary

A leading company in the insurance sector seeks a Claims Manager to oversee complex claims resolution with minimal supervision. Responsibilities include investigating claims, negotiating settlements, and maintaining customer relations. Candidates should possess licensure in multiple states and experience in handling environmental claims. This position offers the opportunity to work in a dynamic environment with a focus on effective claims management practices.

Qualifications

• Experience handling GL Environmental and Asbestos claims.
• Ability to create responsive work products and negotiate settlements.
• Effective oral and written communication skills.

Responsibilities

• Manage claims caseload from assignment through resolution.
• Investigate and evaluate claim coverage, liability, and damage issues.
• Review, analyze, and interpret insurance policy conditions.

Skills

Communication Skills

Negotiation

Judgment on Complex Situations

Customer Relations

Education

FL and/or TX plus NY and CA licenses

Job description

Description

With minimal to no supervision, manage a claims caseload from assignment through resolution. Timely, accurately, and efficiently assess claim coverage, liability, legal, and damage issues. Investigate, evaluate, and, through negotiation, mediation, arbitration, or litigation, achieve resolution of all assigned claims, including complex claims. Maintain good customer relations, good working relations with co-workers, and other company personnel. Substantial independent action is required to resolve complex coverage, factual, and legal issues. Keep claims and jurisdictional knowledge current. Occasional business travel may be needed.

Job Responsibilities

Timely, accurately, and efficiently perform the following responsibilities, plus any other assigned by the manager; advise management on matters relating to these responsibilities:

1. Review, analyze, and interpret insurance policy conditions, exclusions, and endorsements to resolve coverage and liability issues for all lines of business;
2. Prepare reservation of rights letters, nonwaiver agreements, and coverage disclaimers to address claim coverage issues and partner with coverage counsel as applicable;
3. Evaluate claim reserves timely and appropriately, including periodic evaluations to ensure reserves reflect potential exposure;
4. Prepare case summary reports for management regarding significant exposure and reserve concerns;
5. Investigate claims to evaluate coverage and legal issues, including meeting with insureds and witnesses, obtaining statements, medical records, experts, defense counsel, and other relevant evidentiary materials; overall evaluation of each claim's liability and damages, and the company's negotiating stance;
6. Document investigation and claims handling activities thoroughly;
7. Complete or oversee completion of company reports for claims files;
8. Attend and negotiate through mediations, arbitrations, settlement conferences, or other court-supervised settlement efforts. Settle claims with claimants, insureds, and their lawyers;
9. Manage claims proactively to resolution, preparing releases, proof of loss, and similar documents, and authorize settlement funds;
10. Provide direction to and manage defense counsel, independent adjusters, and other third parties, including TPAs, involved in claims;
11. Familiar with reinsurance terms and concepts; communicate effectively with internal staff (management, accounting, etc.)
12. Develop, maintain, and enhance good working relations with colleagues and other personnel necessary for job responsibilities;
13. Maintain current knowledge of corporate, claims, and jurisdictional environments;
14. Keep leadership informed of industry trends impacting the business;
15. Participate in organizational projects as required.

    #LI-Remote

    Qualifications

    • Experience handling GL Environmental and Asbestos claims nationwide required
    • FL and/or TX plus NY and CA licenses required
    • Ability to create responsive work products, achieve results, and provide prompt, efficient, and effective claims and customer service
    • Effective oral and written communication skills with customers, claimants, counsel, and the public
    • Develop and maintain good customer relations with insureds, agencies, and their representatives
    • Make judgments on complex factual situations, negotiate settlements, and decide on coverage issues, including severe bodily injury claims
    • Recognize and interpret claims issues and make appropriate coverage decisions
    • Apply and interpret state law cases and statutes related to liability, antifraud, insurance, tort, and contract law
    • Read, understand, and interpret insurance policies for coverage and liability issues and apply them to claims
    • Comply with fair claims practice statutes and legal requirements
    • Follow company procedures
    • Work independently with minimal supervision, including field operations occasionally
    • Maintain high-quality work output

    The above job description is not exhaustive of all duties, responsibilities, abilities, and functions associated with this role.