Commercial Litigation Claims Examiner

Job Summary:

Analyze complex coverage issues, investigates, evaluates, reserves, negotiates and settles assigned commercial liability claims in litigation accordance with Best Practices. Provides quality claim handling and superior customer service on assigned claims, while engaging in indemnity and expense management. Promptly manages claims by completing essential functions including contact review and interpretation, thorough investigation into facts of loss, damages development and review, evaluation of bodily injury and property damage, proper reserving, litigation management, and claim disposition. Interprets commercial construction contracts, hold harmless agreement, indemnification agreements and contractual liability defense and indemnity provisions. Works closely with assigned coverage and defense counsel.

Essential Duties and Responsibilities:

• Ensure the validity of litigated claims while maintaining Heritage's commitment to superior customer service and support.

• Manage third party defense costs associated with assigned claims according to Legal Department policies and practices.

• Manage and implement defense strategies in accordance with Heritage Litigation Guidelines and procedures.

• Develop an appropriate initial litigation plan with defense counsel following up on all additional investigation, discovery, and the production of related documents as needed.

• Negotiate and settle claims, attending mediations and trials as needed.

• Present high-level summaries of litigated files to involved executive staff.

• Analyze/evaluate insurance policy coverage and issue appropriate reservation of rights letters, and or disclaimer letters and respond to tender letters.

• Handle complex commercial liability claims.

• Makes timely initial contact and appropriate follow-up contact on new losses with insureds and claimants to provide explanation of the claims process, set expectations and gather necessary facts to address coverage, liability and damages.

• Conducts timely coverage analysis and communication with insured based on application of policy information, facts, or allegations of each case. Consults with AVP Liability Claims on use of Claim Coverage Counsel.

• Investigates each claim through prompt contact with appropriate parties such as policyholders, claimants, OSHA, law enforcement agencies, witnesses, agents, medical providers, general contractors, subcontractors, architects, engineers, and technical experts to determine the extent of

liability, damages, and contribution potential. Records necessary statements.

• Identifies resources for specific activities required to properly investigate claims such as U/W, Subro, Fire or Fraud investigators and to other experts. Requests through AVP Liability Claims and coordinate the results of their efforts and findings.

• Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damage documentation. Utilizes risk transfer opportunities and timely addresses the potential for "other insurance" clauses to implead additional parties.

• Maintains an effective diary management system to ensure that all claims are handled timely. Evaluates liability and damages exposure, and establishes proper indemnity and expense reserves, at required time intervals and completes timely Large Loss Notices to Management.

• Utilizes evaluation documentation tools in accordance with department guidelines.

• Responsible for prompt, cost effective, and proper disposition of all claims within delegated authority.

• Negotiates disposition of claims with insureds and claimants or their legal representatives. Recognizes and implements alternate means of resolution.

• Manages litigated claims as assigned. Develops litigation plan with staff or panel counsel, track, and control legal expenses. Assures cost-effective resolution.

• Maintains claim files, has an effective diary system, and documents claim file activities in accordance with established procedures.

• Attends depositions, EUOs, mediations, arbitrations, pre-trials, trials, and all other legal proceedings, as needed. Some travel may be necessary.

• Maintains compliance with Claim Department's Best Practices and company policies and procedures.

• Communicate effectively and courteously with all internal and external letters with communication appropriate to the audience at hand.

SKILLS AND ABILITIES:

• Exceptional customer service skills

• Emotional intelligence and ability to manage conflict.

• Advanced analytical, problem-solving and decision-making skills.

• Ability to communicate effectively verbally and in writing with varying audiences. Ability to convey complex ideas in an understandable and professional way in both written and verbal communication is a must.

• Ability to work independently and make decisions within scope of authority.

• Highly developed organization skills with ability to meet deadlines in a fast- paced environment.

• Self-motivated and results driven.

• Excellent negotiation skills and track record of proven results

• Team-player who is comfortable working in a dynamic, entrepreneurial environment.

• Willingness to simultaneously work on multiple projects and fulfill multiple roles.

• Proven leadership and mentoring capabilities.

• Ability to interpret a variety of policy forms and endorsements.

• History of litigation claims management and working effectively with defense counsel

• Familiarity with reading and interpreting contracts, statutes and case law

• Strong computer skills and advanced knowledge of Microsoft products

Job Qualifications:

• Associates degree. Bachelor's degree or higher preferred

• 10 years liability claim handling experience (multi-jurisdiction preferred)

• 5 years bodily injury evaluation and negotiation experience (serious injury preferred)

• 5 years commercial general liability claim handling.

• 5 years claim litigation experience.

• HOA/Condominium claim handling experience with ability to read and interpret HOA/Condominium and property management documents preferred.

• Licensed to adjust claims in Florida (multi-state licensing preferred)

General Information:

All employees must pass a pre-employment background check. Other checks may be needed based on position: driving history, credit report, etc.

The preceding job description has been designed to indicate the general nature of the work performed; the level of knowledge and skills typically required; and usual working conditions of this position. It is not designed to contain, or be interpreted as, a comprehensive listing of all requirements or responsibilities that may be required by employees in this job. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.

Heritage Insurance Holdings, Inc. is an Equal Opportunity, Affirmative Action Employer. We will not discriminate unlawfully against qualified applicants or employees with respect to any term or condition of employment based on race, color, national origin, ancestry, sex, sexual orientation, age, religion, physical or mental disability, marital status, place of birth, military service status, or other basis protected by law.