Senior Adjuster / Adjuster III

Summary:

The Adjuster III investigates, evaluates, and adjusts assigned claims, which typically consist of medium to complex non-litigated and litigated general liability, third-party automobile bodily injury and property damage claims and may include claims involving more specialized lines of business. Must be qualified legally and technically to handle all claims competently and able to handle more complex, litigated claims.

Principal Duties & Responsibilities

Based on the area of responsibility, the employee shall be asked to perform all of the following essential functions, and other duties as assigned: Investigate, analyze, and determine the extent of the client’s liability concerning personal, casualty, or property loss or damages. Correspond with or interview employees of the client, medical specialists, agents, witnesses, or claimants to compile information. Obtain all necessary reports and documents to analyze and evaluate the loss or damages and attempt to effect settlements with claimants when appropriate.

Investigate claims:

• Assess and estimate vehicle damage or property damage.
• Compile information through interviews.
• Obtain various client records
• Evaluate customer records.
• Examine evidence to determine if it will support claims.
• Search legal records.
• Interview, telephone, and/or correspond with claimants and witnesses.
• Assist with business or managerial research.
• Follow contract, property, or insurance laws.
• Follow rules of evidence procedures in a legal setting.
• Gather physical evidence.
• Inspect properties to determine damages.
• Research property records.

Evaluate Liability Exposure:

• Review insurance applications or contracts.
• Review insurance policies or memorandum of coverage to determine appropriate coverage.
• Obtain, review, and evaluate records; police, medical, etc.
• Recommend claim action.
• Properly reserve for the claim.
• Adjust reserves as appropriate.
• Comply with accepted guidelines regarding reserving practice and authority levels.

Create & Maintain Records:

• Maintain records, reports, and files which are primarily found on the CMIS.
• Comply with all reporting requirements and steps set out in the Company Procedure Manual.
• Comply with regulatory requirements.
• Maintain all cases on an active diary on the CMIS pursuant to established Company criteria.
• Prepare timely reports for clients.
• Document spoken or written information on the CMIS.

Litigation Management Support:

• Collect evidence to support contested claims in court.
• Select and manage defense and coverage counsel.
• Select and manage experts.
• Keep clients advised.
• Provide direction to defense counsel in managing litigated cases.
• Attend litigation hearings including settlement conferences and mediation, requiring travel that could exceed two hour each way.

Requirements

Education and/or Experience:

• Four-year college degree (preferred).
• Possess comprehensive knowledge relating to the handling of public entity liability claims.  
• At least five (5) years’ experience with insurance claims, self-insurance, pooled insurance, or Joint Powers Authorities (JPAs).
• At least three (3) years of using Microsoft Windows on a PC including Microsoft Word, Excel, Outlook (please take out PowerPoint).
• At least two (2) years of using streaming video conferencing including Teams and Zoom with the ability to set and host group meetings with all included functionality.
• At least two (2) years of using claims management software and/or ability to quickly learn new software systems related to claims management.
• Excellent written and verbal communication skills.

Requirements

Education and/or Experience:

• Four-year college degree (preferred).
• Possess comprehensive knowledge relating to the handling of public entity liability claims.  
• At least five (5) years’ experience with insurance claims, self-insurance, pooled insurance, or Joint Powers Authorities (JPAs).
• At least three (3) years of using Microsoft Windows on a PC including Microsoft Word, Excel, Outlook (please take out PowerPoint).
• At least two (2) years of using streaming video conferencing including Teams and Zoom with the ability to set and host group meetings with all included functionality.
• At least two (2) years of using claims management software and/or ability to quickly learn new software systems related to claims management.
• Excellent written and verbal communication skills.