Claims Adjuster

About This Role

This role is responsible for managing a portfolio of complex and high-severity liability claims, including catastrophic injuries and fatalities. The ideal candidate brings strong technical expertise, advanced litigation management skills, and the ability to drive strategic, defensible claim outcomes while maintaining regulatory compliance and exceptional communication standards.

Responsibilities

• Manage a caseload of complex liability claims, including catastrophic injuries and fatality exposures
• Conduct comprehensive investigations, including review of police reports, medical records, expert analyses, and witness statements
• Assess liability, damages, and coverage to make informed, strategic claim decisions
• Partner with defense counsel throughout litigation, including participation in mediations, depositions, and trials as needed
• Negotiate settlements within authority while balancing cost efficiency, risk exposure, and timely resolution
• Communicate effectively with policyholders, claimants, attorneys, and other stakeholders
• Ensure adherence to company policies, regulatory requirements, and industry best practices
• Recommend reserve adjustments based on ongoing claim developments and exposure analysis
• Collaborate with underwriting, product, and legal teams to provide insights on loss trends and emerging risk factors
• Serve as a departmental resource or trainer on complex injury handling and litigation processes

Requirements

• Bachelor’s degree or AIC designation
• Minimum of 5 years of experience handling complex commercial claims and litigation
• Advanced understanding of state-specific unfair claims practices regulations, policy contracts, and commercial insurance principles
• Strong knowledge of tort law, coverage analysis, litigation procedures, and negotiation strategies
• Proficiency in interpreting medical records, accident reconstruction reports, and legal filings
• Solid understanding of medical, automotive, and liability terminology
• Excellent verbal and written communication skills
• Exceptional organizational, time management, and decision-making abilities

Nice to have:

• Experience with construction liability, D&O, or E&O claims preferred