Claims Specialist

• To analyze Lost-Time Workers Compensation claims on behalf of our valued clients to determine benefits due.
• Ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Workers Compensation Claims Adjuster – DE & CT Jurisdiction Knowledge Required – PA NJ MA Preferred

• Provide excellent customer service while managing approximately 95 Short-Term Disability (STD) claims.
• Oversee a portfolio of complex claims, including those involving co-morbidities, behavioral health issues, and self-reported symptoms.

Senior Disability Claims Examiner, Concierge Team

• Investigate, evaluate, and help resolve claims
• Responsible for the resolution of claims of low complexity and exposure
• Review claim information to determine coverage and recommend appropriate next steps
• Assist with evaluating potential exposures on claims and alerting Management or internal partners when needed
• Adhere to Fair Claims Practices Regulations and claims handling guidelines
• Prepare and distribute claim reports
• Build strong relationships with internal stakeholders including Underwriting
• Collaborate with departments across Markel including Claims Vendor Management, Finance, Actuarial, Risk Management, and IT
• Mentor with senior examiners and managers to observe negotiation strategies and claim resolution practices
• Travel to other claim offices and conferences as needed

Associate Claims Examiner

• Investigate, negotiate and settle complex primary and excess policy casualty claims including negligence, premise liability, commercial automobile, construction bodily injury, construction defect, product liability, and sexual assault
• Investigate and analyze coverage under primary and excess casualty insurance policies; make coverage determinations; draft routine and complex coverage correspondence; effectively communicate coverage positions to policyholders and other stakeholders; manage claims involving coverage litigation
• Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist internal business partners, including claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues
• Communicate with underwriting as needed to manage claims and to alert of any significant developments
• Promptly communicate with management on adverse case developments and provide information on pertinent issues affecting professional liability product lines
• Proven ability to work in a collaborative team environment
• Analyze and convey summations of complex issues; recognize alternative approaches and develop action plans, both orally and in written form
• Maintain and adhere to internal guidelines and procedures
• Ensure proper adherence to internal reporting requirements
• Contribute and assist in the implementation of a wide range of initiatives, discussion and action plans brought forth by management
• Participate in agent related functions and meetings as required
• Actively participate in the ongoing training and development of the claims examiners

Executive Claims Examiner

• To analyze Medical Only & Lost-Times Workers Compensation claims on behalf of our valued clients to determine benefits due.
• Ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution.
• Investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Workers' Compensation Claims Adjuster

• To analyze Auto, General Liability & Product Liability claims on behalf of our valued clients.
• Determine benefits due while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.

Commercial Liability Claims Examiner – Auto, General Liability & Product Liability

• Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis
• Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care
• Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposures
• Maintain contact with any/all associated claims carrier(s)’ claims staff, business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary
• Investigate claims and review the insureds' materials, pleadings, and other relevant documents
• Identify and review each jurisdiction's applicable statutes, rules, and case law
• Review litigation materials including depositions and expert's reports
• Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues
• Retain counsel when necessary and direct counsel in accordance with resolution strategy
• Analyze coverage, liability and damages for purposes of assessing and recommending reserves
• Prepare and present written/oral reports to senior management setting forth all issues influencing evaluations and recommending reserves
• Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter
• Negotiate resolution of claims
• Select and utilize structure brokers
• Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims

Claims Examiner, General Liability

• Investigates origin and cause of high exposure claims by contacting the appropriate parties including insureds, claimants, agents, attorneys, contractors, experts, special investigation unit, other adjusters, public personnel, etc.
• Checks for prior claims and recognizes environmental exposures.
• Participates in High Damage Reviews (HDR) to address coverage issues and exposure.
• Handles claims on a good faith basis.
• Handles both 1st party and 3rd party claims under multiple policy types and numerous endorsements.
• Conducts on-site inspections when needed, evaluates damages and handles claim negotiations with insureds, claimants, attorneys, public adjusters.
• Interprets and determines policies, leases, by-laws, declarations, articles, and contract coverages and applies to all parties for assigned losses.
• Proactively provides all parties with claim process and status as appropriate; answers questions or redirects to other areas.
• Serves as a mentor and subject matter expert for less experienced adjusters.

Large Loss Property Field Claims Adjuster

• To analyze mid to high level Workers Compensation Lost-Time claims on behalf of our valued clients to determine benefits due.
• Ensuring ongoing adjudication of claims within service expectations.
• Investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Workers Compensation Claims Adjuster, NJ & VA Jurisdictions, Dedicated Client, Capped Caseload

• Managing primary claims involving New York Labor Law for AXIS U.S. Primary Casualty policies.
• Evaluating complex New York Labor Law claims to determine appropriate settlement strategies and ensure adherence to company policies.
• Ensuring timely evaluation, reserving and disposition of assigned New York Labor Law claims.
• Mentoring junior claims adjusters, providing guidance and support to enhance their professional development.
• Utilizing working knowledge of the legal frameworks and claims handling practices relevant to the specific jurisdiction (i.e., NY) in which the claims arise.
• Documenting coverage, investigation, damages, reserve rationale, negotiations, etc. associated with claim.
• Reviewing contracts for risk transfer evaluations, coverage analysis and tender review.
• Investigating potentially fraudulent claims and taking appropriate action.
• Identifying opportunities for contribution, subrogation and contribution to the claim.

Senior Claims Specialist, Primary Casualty Construction Claims

• Investigate, analyze, and evaluate Third Party Liability claims
• Determine appropriate valuation and recommend settlement strategies
• Travel for mediations and trial observations
• Collaborate with internal and external teams
• Develop claims and litigation strategies

Senior Claims Specialist

• Responsible for the resolution of low to moderate complexity and exposure Personal Lines Marine physical damage claims in multiple jurisdictions
• Confirms coverage of claims by reviewing policies and documents submitted in support of claims
• Analyzes coverage and communicates coverage positions
• Ability to draft coverage position letters independently
• Utilizes acceptable investigation claims handling and settlement techniques that achieve cost effective and timely closure results
• Conducts, coordinates, and directs investigation into loss facts and extent of damages
• Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure
• Sets reserves within authority or makes recommendations concerning reserve changes to manager
• Utilizes diary system to pro-actively resolve outstanding issues and to ensure timely processing and closure of the claim
• Negotiates and settles claims directly with claimant
• Prepares reports by collecting and summarizing information
• Provides timely service throughout the life cycle of the claim by meeting all service level agreements
• Identifies subrogation opportunities and fraud potential and makes appropriate referrals

Claims Examiner II – Marine Personal Lines

• Investigate and resolve commercial auto liability and physical damage claims related to trucking
• Review policy language to determine coverage and consult with coverage counsel as needed
• Manage a caseload of moderate to high complexity claims, including higher exposure files
• Communicate with insureds, claimants, attorneys, repair facilities, and law enforcement to gather information
• Work with defense counsel and vendors on litigated claims and recovery efforts
• Handle claims in accordance with company guidelines and regulatory requirements
• Participate in file reviews, team meetings, and training

Senior Trucking Liability Claims Adjuster, JD Required

• Responsible for the resolution of moderate to high complexity and moderate to high exposure claims
• Handle claims from coverage enquiry through legal liability assessment (where relevant) and quantum analysis
• Ensure timely and accurate resolution; communicate developments and outcomes to stakeholders
• Confirm coverage of claims by reviewing policies and documents
• Analyze coverage and communicate coverage positions
• Prepare coverage position letters and assist in investigation and settling of claim
• Conduct, coordinate, and direct investigation into loss facts and extent of damages
• Direct and monitor assignments to experts and outside counsel
• Evaluate information on coverage, liability, and damages
• Set reserves and negotiate claims typically in litigation within authority
• Present at roundtables to senior claims leaders and underwriters
• Participate in special projects having an impact on the business

Senior Claims Examiner

• Investigate, evaluate, negotiate and settle assigned claims
• Collect and analyze data according to policy application and/or contract provisions
• Confirm coverage of claims by reviewing policies and documents
• Analyze coverage and communicates coverage positions
• Draft coverage position letters independently
• Conduct, coordinate, and direct investigation into loss facts and extent of damages
• Evaluate information on coverage, liability, and damages
• Set reserves within authority or make recommendations concerning reserve changes
• Utilize diary system to resolve outstanding issues
• Negotiate and settle claims directly with claimant
• Prepare reports by collecting and summarizing information
• Participate in special projects or assist other team members

Claims Examiner, Inland Marine – Transportation Claims

• Responsible for investigating, evaluating, and negotiating general and auto liability claims
• Conduct timely and accurate investigation, damage evaluation and claim resolution
• Document facts and maintain evidence to support claim resolution
• Establish and review appropriate loss and expense reserves
• Communicate effectively with internal and external customers

Claims Analyst IV – Auto and General Liability

• Handle Employment Practices Liability claims
• Identify, investigate, and resolve multiple coverage issues
• Provide clear communication of policy coverage issues
• Coordinate with defense counsel and insureds
• Analyze and budget litigation on pending claims
• Manage reserve adjustments and payments
• Make presentations to management as necessary

Claims Analyst IV – Management Liability

• Manages, investigates, and resolves claims.
• Investigates and evaluates coverage, liability, damages, and settles claims within prescribed authority levels.
• Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation.
• Prepares for and attends trials, hearings and conferences and reports to Home Office and local management on status.
• Confers with trial counsel and prepares trial reports.
• Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action.
• Responds to various written and telephone inquiries including status reports.
• Ensures adequacy of reserves.
• Accountable for security of financial processing of claims, as well as security information contained in claims files.
• Updates files and provides comprehensive reports as required.
• Responsible for managing the practices and billing activities of outside and in-house counsel.

Senior Casualty Claims Specialist

• Manages an inventory of claims to evaluate compensability/liability
• Plans and conducts claim investigations to confirm coverage and to determine liability, compensability and damages
• Determines and negotiates appropriate claim settlements/reserves within prescribed authority
• May attend arbitrations, mediations, depositions, or trials
• Conveys moderately complex information regarding coverage and settlements to insureds, claimants, and external partners
• Authorizes payments in accordance with assigned authority limit and ensures payments are made in a timely manner
• Maintains accurate and detailed claim files, including all correspondence, reports, and settlement agreements.
• Performs other duties as assigned

Senior Workers Comp Claims Representative

• Manage an inventory of moderate to high complexity and exposure commercial claims
• Following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits
• Deliver the AXIS North America Claims value proposition engaging with stakeholders, brokers, and insureds
• Handle E & S Property Claims for a wide variety of AXIS policyholders
• Ensures understanding and administration of claim policies, procedures, and practices in accordance with company and policy standards
• Review policy wordings to validate coverage for claims and escalate any issues arising
• Work closely with Independent Adjusters, external legal advisors and brokers

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