Job Description

As the Large Loss Casualty Adjuster, you will be responsible for investigating, evaluating, and settling first and third party bodily injury and liability claims. The majority of the claims you will handle will involve Large Losses, Construction Defect, NY Labor Law, Sexual Misconduct, Environmental, Trucking, E&S and Professional Liability. 

You will generally have settlement authority up to $175,000 for liability claims. Supervisor direction should only be required for high-valued, unique, or multi-faceted claims over settlement authority.

You will work out of your home office and require limited supervision. To be successful in this position, you must be familiar with complex claims concepts, practices, and procedures; possess creativity and latitude, and excellent communication and presentation skills. You will rely on experience and judgment to plan and accomplish complex goals.

Accountabilities:

• Handles claims ranging from moderate to complex with considerable latitude for action and decision.
• Makes coverage recommendations and total claim value determinations.
• Investigates coverage and cause of loss on routine to complicated claims, which includes but is not limited to policy review, evaluating current and prior medical history/problems. Interviewing all parties associated with the loss and gathering and analyzing all necessary investigative documentation.
• Reviews, evaluates and negotiates bodily injury claims with unrepresented and represented insureds/claimants including litigation management. Evaluating injury claims and property damage claims will be primary focus. Review medical records and bills to validate accuracy of services provided. Completes bodily injury evaluation summary including liability, damages, causation, diagnosis, treatment, reserves, and general damages.
• Provides accurate assessments and negotiates fair and efficient claims resolutions while managing costs. Settles losses according to the documented damage, the language of the policy of insurance, pertinent regulatory and statutory considerations and within granted authority.
• Prepares written communication, including but not limited to settlement letters, disclaimers of coverage and reservation of rights letters
• Maintains effective claim file documentation and diary system. Monitor diary to achieve timely development of file and timely disposition of the claim
• Recognizes and prepares submissions to SIU when indicated.
• Assigns and supervises vendor resources, including but not limited to independent adjusters, engineers and other experts as needed
• Helps to identify problems that affect team effectiveness or efficiency and recommend changes in procedures.
• Travels and attends mediations or training as needed.
• Assumes additional duties as defined.

Required Qualifications:

• Environmental claim experience is preferred.
• Propane Gas Distributors claim experience is preferred
• Bachelor's degree preferred
• Professional designations are preferred
• 10+ years in the handling of Claims.

Recommended Qualifications:

• Understands concepts of coverage, policy interpretation, exposure recognition and liability determination
• State licensing or certification where required.
• Ability to take responsibility and work independently in a home-based environment.
• Strong communication and analytical skills.
• Ability to negotiate skillfully in difficult situations.
• Must have strong organizational and time management skills.
• Ability to formulate sound expense, indemnity, and business judgment while supporting loss evaluations and presenting them effectively.
• Basic computer skills including Microsoft applications Word, Excel, Outlook and the Internet.
• Perform work related simple and advanced mathematical problems and calculations.
• Compose written correspondence and factual reports which are well-organized and concise, utilizing proper English, grammar, punctuation and spelling.
• Demonstrates the ability to use commonly used claims concepts, practices and procedures.
• Must meet or exceed the ability to demonstrate the 5 core and common competencies outlined below.
• Convey clear, concise information to others, using verbal or other appropriate communication techniques.
• Complete formal training plan and assignments as required.
• Treat others in a non-discriminatory, lawful and ethical manner, respecting the differences among people, and the value they bring to GuideOne.
• Follow safe practices in all work activities to avoid injuries and accidents.

Compensation:

• $79,800 - $133,000 commensurate with experience, plus bonus eligibility
• $87,900 - $146,500 commensurate with experience in CA, CT, MA, NJ, NY, and PA, plus bonus eligibility

Benefits:

We are proud to offer a robust benefits suite that includes:

• Competitive base salary plus incentive plans for eligible team members
• 401(K) retirement plan that includes a company match of up to 6% of your eligible salary
• Free basic life and AD&D, long-term disability and short-term disability insurance
• Medical, dental and vision plans to meet your unique healthcare needs
• Wellness incentives
• Generous time off program that includes personal, holiday and volunteer paid time off
• Flexible work schedules and hybrid/remote options for eligible positions
• Educational assistance

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