Address
Form of workJob Description
Job Description
TITLE: Senior Casualty/General Liability Property Adjuster
DEPARTMENT: National Casualty Practice
REPORTS TO: Casualty Claims Manager
STATUS: Regular, full-time; exempt
PREPARED OR REVISED: October 2021
SUMMARY OF JOB PURPOSE
The Senior Casualty/General Liability Property Adjuster manages all aspects of liability claims in a variety of business classes, effectively determining and communicating the extent of liability or damage associated with each claim. The incumbent assists the client in fulfilling its obligation to policyholders and maintaining the client's claims processing functions, including evaluating potential coverage issues, liability and evaluation of damages, risk transfer opportunities, litigation and settlement matters within the limits of assigned authority levels and in compliance with applicable legal and regulatory requirements. The claims assigned to the adjuster are based on their experience and demonstrated aptitude for handling large or complex matters with minimal supervision.
PRIMARY JOB RESPONSIBILITIES
- Determines appropriate methods and extent of needed investigation for all assigned claims, including conducting investigations through field visits and phone contact; obtaining contracts, job files, and appraisals; conducting insured, witness, and claimant interviews and/or statements; complete site inspections; scope, measure and write estimates, and use other fact-finding methods to evaluate liability, damages, and proper coverage.
- Uses knowledge of property and construction, and/or knowledge of the specific industry or business affected, personally conduct property inspections and photograph claim sites as necessary to depict and substantiate losses or damage, or lack thereof.
- Investigates insurance claims in a variety of settings including, but not limited to retail establishments, office buildings, residences, condominiums, apartments, hotels, corporate facilities, governmental facilities, schools, clinics, or hospitals; assess loss or damage resulting from various events including, but not limited to, inclement or catastrophic weather, construction defect, and fire.
- Conducts thorough interviews or other methods to obtain necessary information from the claimant and experts such as architects, engineers, builders, construction workers, police officers, health care practitioners, accountants, and others to assess the extent of the loss fully and accurately.
- Applies a thorough understanding of insurance policies and policy interpretation to properly conduct an investigation, establish appropriate loss estimates based on all relevant information and findings, provide coverage recommendations, and draft cover letters, if requested by the client.
- Applies an intermediate level of understanding of insurance policies and policy interpretation to properly investigate, provide coverage recommendations, and draft coverage letters, if requested by the client, with minimal supervision.
- Works cooperatively with expert witnesses, attorneys, underwriting department staff, investigators, vendors, and carrier's examiners as needed to conduct investigations, confirm findings, and support evaluations.
- Ensures the accuracy of information collected and reported, and guards against fraudulent claims based on critical issues identified and accurate conclusions drawn.
- Follows all applicable policies, procedures, and practices, and incorporates sound judgement in formulating recommendations and completing evaluations and reports.
- Effectively use software systems such as Xactimate as necessary to produce accurate estimates.
- Prepares accurate, clear, thorough, and concise reports and letters to insurance carriers, providing appropriate conclusions and recommendations.
- Arranges contractors' estimates, and other specialists' appointments as necessary. Attends trials, arbitration, ADR, and face-to-face negotiations as required.
- Assists with monitoring quality of services rendered by appraisers, law firms, structured settlement vendors, rehabilitation vendors and other experts or consultants.
- May be called upon to handle more complex claims involving various situations, including contractor liability, products liability, and construction defects with the appropriate level of guidance.
- Ability to identify claims whose complexity warrants escalation to a more senior level adjuster.
- Identifies and addresses third party liability and tender opportunities through investigation and/or contract interpretation.
- Maintains accurate, thorough field notes, journal entries, and time and expense records as required. Submits reimbursement reports in keeping with organization and client policies, procedures, and practices, and within accepted industry standards.
- Applies knowledge of both time-and-expense and fee-for-service procedures, according to the stipulations of the agreement with the client.
- Functions as an effective member of the team, assisting co-workers as needed and learning from colleagues and supervisors; supports the goals of the department, division, and organization; participate in special assignments and activities as required or approved.
- Establishes and maintains positive working relationships with other members of the organization across departments, divisions, and locations.
- Maintains the confidentiality of proprietary and sensitive information, exercising sound judgment and discretion in any disclosure of information related to EM and its endeavors.
- Upholds the values of Engle Martin and Our Foundation.
- Adheres to all applicable State Insurance Regulation requirements and other applicable laws, regulations, and standards; assumes personal responsibility for maintaining the requisite state licensure for the state(s) assigned.
- Bachelor's degree in a related field or demonstrated equivalent experience
- At least three years of experience in related claims handling preferred.
- Active license or ability to obtain such in multiple jurisdictions
- Proficiency in a variety of office software, including Microsoft Office Suite (including but not limited to Word, Excel, PowerPoint, Outlook, and Adobe)
- Skills in using word-processing, spreadsheet, and database software
- Fundamental understanding of claims adjudication processes; knowledge of commercial and residential construction industries and/or basic knowledge of automotive and transportation industry desirable
- Basic knowledge of casualty claims law and jurisdictional issues
- Fundamental understanding of how to perform codes investigations
- Fundamental knowledge of estimate building through Xactimate
- Understanding of the Commercial General Liability Policy Form
- Sound negotiating, conflict resolution, and persuasion abilities
- Ability to draft coverage letters with some supervision
- Skills in analyzing, interpreting, synthesizing, prioritizing, and reporting pertinent information, discerning the essential from the non-essential
- Proficient written and oral communication skills
- Effective time management and organization skills
- Basic mathematical and statistical skills
- Ability to interpret policies and other written technical information
- Trustworthiness, integrity, and personal accountability and adherence to standards of ethical behavior and professional conduct
- Commitment to confidentiality and ability to discretely handle sensitive information
- Keen service orientation and customer service skills
- Detail-oriented, and the ability to research, investigate and problem solve
- Commitment to professional and personal growth and development
- Team-oriented work style
Work is generally performed in a typical office environment or at loss sites, with limited exposure to harsh weather conditions, loud internal or external noise, fumes, or significant temperature changes. Occasional overnight and extended travel in a work and/or training capacity may be required.
PHYSICAL ACTIVITIES AND REQUIREMENTS
In addition to the working conditions and associated physical activities and requirements above, the incumbent may be required to climb, balance, stoop, kneel, crouch, crawl, reach, stand, walk, push, pull, lift, finger, grasp, or feel, especially in the course of investigating and assessing Property Damage; these requirements may include the need to lift weights of up to 50 pounds, including a ladder.
Periodic driving is required; visual acuity to prepare and read detailed hard copy and electronic documents' ability to speak and to hear the spoken word in normal face-to-face and telephonic business communications; ability to safely operate a motor vehicle in a work capacity.
