Senior Corp Claims Specialist - National Environment and Asbestos Experience

PMA Companies; Philadelphia (Philadelphia County); Remote; USD 70,000 - 90,000; Full time

Job summary

A leading company is seeking a Claims Manager to handle a diverse caseload, focusing on GL Environmental and Asbestos claims. This position requires strong negotiation skills and the ability to work independently. The role may involve occasional business travel and includes significant responsibilities in managing claims resolution and fostering good customer relationships.

Qualifications

• Experience handling GL Environmental and Asbestos claims nationwide required.
• FL and/or TX plus NY and CA licenses required.
• Ability to create a highly responsive work product.

Responsibilities

• Review and analyze insurance policy conditions to resolve coverage issues.
• Investigate claims and evaluate coverage and legal issues.
• Manage claims proactively to resolution.

Skills

Effective communication skills

Negotiation

Judgment on complex factual situations

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

• Review, analyze, and interpret insurance policy conditions, exclusions, and endorsements to resolve coverage and liability issues for all lines of business.
• Prepare reservation of rights letters, nonwaiver agreements, and coverage disclaimers to address claim coverage issues and partner with coverage counsel as applicable.
• Evaluate claim reserves timely and appropriately, including periodic evaluations to ensure reserves reflect potential exposure.
• Prepare case summary reports for management related to significant exposure and reserves.
• 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.
• Provide documentation of investigation and claims handling activities.
• Complete or direct others to complete company reports for claims files.
• Attend and negotiate through mediations, arbitrations, settlement conferences, or other court-supervised settlement efforts. Settle and resolve claims with claimants, insureds, and their lawyers.
• Manage claims proactively to resolution, preparing releases, proof of loss, and similar documents, and authorizing settlement funds.
• Provide direction to and manage defense counsel, independent adjusters, and other third parties, including TPAs, assisting in claims.
• Develop, maintain, and enhance good working relations with co-workers and other personnel necessary for job responsibilities.
• Maintain current knowledge of corporate, claims, and jurisdictional environment.
• Keep leadership informed of industry trends that may impact the business.
• 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 a highly responsive work product that meets customer needs and supports efficient claims handling.
• Effective communication skills, both oral and written, with internal and external parties.
• Develop and maintain good customer relations with insureds, agencies, and their representatives.
• Make judgments about complex factual situations, negotiate settlements, and make decisions regarding all lines, including severe bodily injury claims.
• Recognize and interpret claims issues timely and accurately, making appropriate coverage decisions.
• Apply and interpret applicable state law cases, statutes, and legal principles concerning liability, antifraud, insurance, tort, and contract law.
• Read, understand, and interpret insurance policy contracts for all lines and apply them to factual situations.
• Comply with fair claims practices statutes and other legal requirements.
• Follow company procedures and work independently with minimal supervision, including field operations.
• Maintain high-quality work output.

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