Claim Specialist responsible for managing complex construction defect claims and ensuring thorough resolution with stakeholders. Work involves elaborate analysis and litigation management with high-value claims.
Responsibilities
The Claim Specialist must demonstrate the ability to independently and timely manage all aspects of the most complex, high-value claims exhibiting a detailed knowledge of each claim, a well-reasoned analytical focus, and a clear strategy for resolution.
Provide proactive communications to customers and business partners in the management and resolution of claims
Respond to inquiries from customers and provide superior customer service
Review and analyze multiple complex policies and coverage parts (including general liability, contractors professional liability and wrap-up policies)
Write and articulate clear, concise and accurate coverage positions
Effectively manage litigation and counsel, inclusive of litigation planning, budgeting, and proactively positioning claims for resolution
Develop complex coverage, liability and damage assessments and persuasively articulate them to leadership
Provide detailed impactful recommendations to leadership
Pursue and finalize coverage and liability risk transfer against other liable parties and insurance carriers
Conduct complex negotiations and articulate coverage/liability positions
Attend mediations and trials as necessary
Proactively manage accurate expense, reserve and financial transactions
Consistently maintain up to date claims metrics
Requirements
5+ years construction defect claim handling experience
Experience handling complex construction defect coverage and liability issues on general liability and WRAP policies for general contractor, developer, owner, and construction manager claims
Experience in handling affirmative/defensive risk transfer, including tendering and responding to additional insured and contractual indemnity tenders
Excellent verbal and written communication skills
Excellent analytical and critical thinking ability
Ability to present in a roundtable setting with a well-reasoned and analytical evaluation
Experience in the creation and delivery of presentations
Superior customer service skills and active listening skills
Proven track record of prioritizing and managing multiple responsibilities simultaneously
Proven track record of effective negotiations/settlement of high-value construction defect liability claims
Demonstrated negotiation and conflict resolution skills
Proficiency with MS Office, especially Word and Excel
Active Property & Casualty State Insurance Adjuster license
Benefits
Other rewards may include short-term or annual bonuses
Workers’ Compensation Claims Representative at West Bend, guiding injured employees through the recovery process and ensuring fair claim resolution. Opportunity to lead with confidence in problem - solving and negotiation.
Bodily Injury Claims Specialist managing a large inventory of complex claims for National Interstate Insurance. Conducting investigations and analyzing settlements for compensability and liability issues.
Entry - level Claims Representative II Trainee providing foundational claims handling at Inservco Insurance Services. Assisting in basic claims under supervision while learning best practices and customer service.
Claims Examiner at ICW Group managing complex claims while providing exceptional service. Focused on resolution strategies, collaboration, and regulatory compliance in the insurance sector.
Sr. Claims Examiner handling litigation losses for insurance brokerage in Garden City, NY. Investigating claims, managing adjusters, and ensuring proper loss reserving in a hybrid work environment.
Claims Representative II managing moderate - to - complex bodily injury and general liability claims. Investigating losses, determining liability, and negotiating settlements in various states of the US.
Claims Examiner responsible for adjudicating workers' compensation claims for California clients. Analyzing claims, negotiating settlements, and ensuring compliance with client service requirements and industry standards.
Claims Examiner analyzing complex workers' compensation claims for Sedgwick, a global risk and claims administration leader. Ensuring claims adjudication meets service expectations and client requirements.
Claims Representative role in training for workers' compensation at Sedgwick. Involves investigation and resolution of claims with ongoing professional development.