Sr. Claims Examiner II

Global Indemnity Limited Bala Cynwyd , PA 19004

Posted 5 months ago

Position & Responsibilities:

  • In accordance with Company policies and in support of the Claims Department's mission, the Claims Examiner II has the responsibility to ensure outstanding claims service.

  • Promptly investigates each claim in accordance with the claims Department Best Practices.

  • Initiates contact with insureds, claimants, witnesses, attorneys and other appropriate parties.

  • Sets schedule for investigation, including determination of appropriate witnesses and parties to contact

  • Reviews and evaluates policy coverage provisions, business classifications and underwriting guidelines.

  • Makes recommendations regarding the handling of coverage issues.

  • Composes reservation of rights letters, non-waiver agreements and coverage declination letters.

  • May direct counsel on approved declaratory judgment actions.

  • Oversees and controls investigation assignments made to independent adjusters and other vendors.

  • Uses independent judgment to review and audits all vendor invoices.

  • Sets initial reserves and ensures proper reserve evaluations throughout the life of a claim.

  • Maintains an organized claim file, including appropriate file documentation.

  • Maintains an effective and timely diary in accordance with Best Practices.

  • Works with counsel to ensure they are in compliance with the Department's Litigation Management Plan and Billing Guidelines.

  • Uses judgment and discretion to equitably investigate, negotiate reserves and resolve all claims within the prescribed authority level, authorized by Senior Management.

  • Recognizes and pursues potential opportunities using experienced judgment for recovery including subrogation, indemnification and/or contribution.

  • Recognizes and refers potential suspicious claims or claims activity, based on experienced judgement, to the SIU in accordance with the Claims Department Best Practices.

  • Establishes and maintains business relationships with Underwriting and reinsurers, as well as agents, insureds attorneys, vendors and other parties as appropriate.

  • Provides timely and proper notification and updates to reinsurers.

  • Participates in weekly roundtable meetings on claims issues.

  • Completes special projects and performs other duties as assigned by the Claims Manager.

Requirements & Qualifications:

  • Ten years minimum of technical experience required.

  • Experienced claims professional who must possess a knowledge of coverage, statutory requirements and claims handling regulations.

  • High degree of technical skill and expertise required to recognize and resolve technical claims issues and recommend and implement solutions within the granted authority.

  • Requires excellent interpersonal skills and a high degree of initiative and decisiveness.

  • Shows ability to use independent judgment and discretion in decision-making, including claims analysis.

  • Ability to communicate with all levels of company management as well as the general public, attorneys and the company's general agents in a professional manner.

  • Must have strong analytical skills and knowledge of policy construction, and forms used by the Company.

  • Must have strong computer skills with knowledge of Windows operating systems plus Word, Excel, PowerPoint and ImageRight.

  • Must be able to effectively understand construction terminology, estimating systems, and building evaluations.

  • Knowledge of the legal invoice review process (TyMetrix software) is a plus.

  • Must possess or acquire adjuster licenses and complete CE requirements as needed.

  • Must be able to travel on company business as needed.

  • College degree or equivalent work experience required.

  • Additional insurance related education/designation such as CPCU, AIC, AIM, SCLA, etc, preferred.

  • Other advanced degrees are a plus.

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