Investigate, negotiate and conclude by settlement or denial complex and challenging litigated claims, including litigation in multiple different states, venued in state or federal courts. Must have expertise in commercial and personal lines, as well as coverage, contractual and legal issues. Develop and execute litigation strategy, and manage the activities of assigned defense counsel to ensure cost effective resolution of litigated claims. Litigated claims handled may be large and complex involving a large amount of legal expenses. The individual in this position will also ensure claims are processed within company policies, procedures, and individual's prescribed authority with exceptional standards of performance. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements.
Preferred Offices: Allentown, PA , Horsham, PA, Branchville, NJ, Hamilton, NJ or Charlotte, NC
Open to work from home for the right candidate.
- Analyze ISO and manuscript policy forms to determine coverage as well as prepare well written Reservation of Rights and Disclaimers to properly convey the coverage decision to the proper parties.
- Investigate litigated claims through telephone, written correspondence, and/or personal contact with claimants, attorneys, insureds, witnesses and others having pertinent information. Attend depositions, mediations and trials as needed.
- Analyze information, including depositions, expert reports, attorney evaluations, and medical reports, gained from discovery during litigation in order to evaluate assigned claims to determine the extent of loss, taking into consideration contributory or comparative negligence. Assign medical or other experts to case and arrange for medical examinations when necessary.
- Process incoming calls and correspondence from insureds, claimants and agents regarding questions or problems associated with claims. Interact with underwriters and agents on claim resolution.
- Accurately update the claim file to reflect the liability analysis based on the developed investigation.
- Make appropriate reserve recommendations based on the medical and liability information that has provided in a timely fashion.
- Obtain and review budgets from panel counsel to determine defense strategies and accurate expense reserves for the claim.
- Prepare check requisitions for all loss and expense payments.
- Explore subrogation potential on all claims.
- Prepare for and participate in claims review and settlement conferences.
- Evaluate, negotiate and settle litigated claims within delegated authority. Handle litigation files from start to finish.
- Close claim by issuing check or denial and securing appropriate releases and closing documents.
- Must be able to handle litigation files from start to finish.
- College degreepreferred.
- Prefer 7-10 years claimsexperience.
- CPCU designation/course work, Senior Claims Law course work, or other industry training/designations preferred.
Job ID 5860