Sr. Liability Claims Examiner

Job Summary

The Senior Liability Claims Examiner is responsible for investigating and resolving complex, liability insurance claims in accordance with policy provisions, regulatory requirements, and company best practices. This role requires advanced technical expertise in coverage analysis, liability determination, and claim valuation, while ensuring timely and fair claim resolution. The Senior Claims Examiner may also provide guidance and mentoring to junior claims staff, collaborate with legal counsel on litigated matters, and contribute to risk management and loss-control initiatives to minimize financial exposure and enhance customer satisfaction.
Reports To: Claims Supervisor

Duties/Responsibilities

• Liability claims investigation, evaluation, negotiation, and resolution.
• Coverage evaluation, timely and accurate reserving, and vendor management required.
• Heavy phone and direct contact with all parties concerning the claim process.
• Other duties may be assigned as determined by management.
• Recommends and enters potential exposures to management for approval within company guidelines.
• Promptly contacts insureds and claimants and conducts an investigation into the facts of the loss as directed and within company guidelines for Best Practices.
• Excellent customer service in all aspects of claims handling.
• Answer correspondence received in conjunction with the claim in accordance with state guidelines. Returns telephone calls same day.
• Makes investigative reports promptly to the file with clear and concise file documentation. Makes initial reports to the files as directed by management.
• Communicates effectively both orally and in writing with management and non-management personnel as well as insureds.
• Payments made in accordance with the laws established by the state. All payments are to be made within the guidelines for Best Practices.
• Maintains a working diary as per Company guidelines for each assigned claim file which includes timely, accurate entry of data.