ESIS ProClaim Specialist (Hybrid)

JOB DESCRIPTION

ESIS ProClaim is seeking an experienced General Liability representative.

Ideally the candidate would be based out of our Jersey City or New York office but we are open to other cities and arrangements.

In this role you will adjudicate liability claims from first notice of loss to resolution under general supervision of a team leader.

Note: This is a hybrid position requiring 3 days in the office and 2 days working from home.

KEY OBJECTIVE

Under the direction of the Claims Team Leader, Senior Claim Adjuster will handle commercial auto, general liability, property and/or products liability claims.

Responsibilities will include determines coverage, investigates facts of third-party claims, assesses, and apportions liability and settles claims at the best outcome within established claim best practices guidelines and client instructions.

We are seeking a professional with experience in handling New York Labor Law claims.

RESPONSIBILITIES

Duties include but are not limited to:


* Under supervision, receives assignments and reviews claim and policy information to determine coverage, conducts a thorough investigation and may determine the extent of the policy's obligation to the insured depending on the line of business.


* Maintain diary system to ensure each file is reviewed at a minimum of every 30 days


* Conduct investigations to secure necessary claim information.


* Proactively and aggressively manages defense counsel and litigation working collaboratively with defense counsel, as directed by the client.


* Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extent of the insurance carrier's obligation to the insured under the policy contract.


* Prepares detailed 90-day Claim Summary Reports and provide updates to the client on investigation, potential settlement opportunities, claim denials, reservation of rights, third party tenders and recommendations to present at claims review meetings.


* Posts in claim system, loss and expense reserves within authority limits and recommends reserve changes above authority to Team Leader.


* Reviews progress and status of claims with Team Leader and discusses problems and suggested remedial actions.


* Prepares and submits to Team Leader unusual or possible undesirable exposures such as bad faith or unfair claim practice allegations.


* Assists Team Leader in developing methods and improvements for handling claims.


* Settles claims promptly and equitably once authority is obtained.


* Obtains appropriate releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.


* Informs claimants, insureds/customers, or plaintiff attorney of denial of claim when applicable.

QUALIFICATIONS



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