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Acadia Insurance (a Berkley Company) · 2 hours ago

Complex Claims Specialist

IN, Indianapolis - Field Address

Full-time

Onsite

Mid, Senior Level

3+ years exp

Carolina Casualty is a member of W. R. Berkley Corporation, specializing in commercial lines insurance. The Complex Claims Specialist role involves analyzing and resolving complex claims, conducting investigations, and ensuring high-quality claim handling while providing support to the claims team.

Commercial InsuranceInsurance

No H1B

Responsibilities

Adjusts and resolves complex to severe commercial claims that may also include all phases of litigation for our Bodily Injury team

Plans and conducts investigations of high severity claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners. Refers to claim to subrogation group or Special Investigations Unit as appropriate

Assesses policy coverage for submitted claims and notifies the insured of any issues

With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters

Determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim

Reviews and analyses claim documentation and legal filings

Assesses actual damages associated with claims and confidently conducts negotiation within assigned authority limits, to settle claims

Coordinates the litigation activities associated with assigned claims to ensure a timely and cost-effective resolution; attends trials as a representative of the company

Acts as senior technical professional on team, assisting team members with escalated issues

Develops and maintains excellent rapport with our agency force, insureds, claimants, experts, attorneys, and internal customers

Attend mediations, trials, and overnight travel as needed

Qualification

Claims case handlingLiability analysisLitigation managementAdvanced analytical skillsCoverage analysisNegotiation skillsInvestigative skillsVerbal communicationWritten communication

Required

Bachelor's Degree

Demonstrates an advanced knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the state`s tort laws as normally acquired through a bachelor`s degree (or equivalent training) plus 3 to 5 years directly related work experience

Ability to investigate and evaluate complex liability claims

Ability to analyze available information and make effective decisions

Ability to evaluate damages and negotiate fair settlements

Advanced analytical skills

Advanced knowledge of coverage within the team's specialty or focus

Litigation and mediation management experience required

Excellent verbal and written communication skills

Strong background in auto and general liability coverage analysis particularly involving commercial claims with complex issues