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HAI Group · 20 hours ago

Senior Claims Examiner (General Liability)

Cheshire, CT

Full-time

Onsite

Senior Level

5+ years exp

HAI Group is the nation’s leading property-casualty insurance company dedicated to affordable housing organizations. The Senior Claims Examiner is responsible for investigating, evaluating, negotiating, and resolving liability claims while mentoring team members and ensuring adherence to claims management standards.

Insurance

Work & Life Balance

Responsibilities

Timely and effectively investigate and evaluate claims while managing outside adjusters and legal counsel

Directs settlement activity using investigative and problem-solving skills in direct negotiations

Handle all assigned cases efficiently and cost-effectively through conclusion

Analyze and recommend appropriate reserves; periodically reviewing and adjusting these reserves based on the assessment of probable liability, financial responsibility and exposure

Handle all assigned cases efficiently and cost-effectively through conclusion, identifying and thoroughly investigating all available risk transfer options (subrogation and third-party recoveries and re-insurance)

Review, analyze and interpret coverage in accordance with applicable policies

Prepare coverage evaluations, document files and draft letters for management review in a timely manner

Concentration on larger cases with reinsurance involvement requiring ability to track aggregates, and prepare more complex reports

Reviews invoices, estimates, legal fees, and other documents to ensure accuracy and legitimacy prior to payment

Prepare clear and concise reports with little or no guidance that can be presented for review and require little or no edits by management

Mentors’ examiners, as well as coordinators, by providing guidance, sharing expertise, and overseeing work product

Serve as Subject Matter Expert for certain venues and/or coverage line

Qualification

Liability claims handlingAll lines adjuster's licenseCoverage analysisAIC designationCompliance processesCustomer service skillsTeam playerWritten communicationVerbal communication

Required

High School Diploma

Bachelor's degree in business management, insurance, or related field required, or equivalent work experience

Minimum 5 years progressive liability claims handling experience for property/casualty insurance company or third-party administrator

All lines property/casualty adjuster's license

Experience analyzing and interpret coverage at a level commensurate with complexity of assigned claims

Experience preparing and communicating written status reports, for policyholders, management and business partners, including treaty and facultative reinsurers, agents and brokers

Understands the litigation process, current relevant case law and statutory law in multiple jurisdictions

Experience implementing compliance processes and procedures to ensure consistent, efficient and effective compliance with all federal, state, local and filed requirements

Maintains adjusting licenses in all required states