ESIS ProClaim Senior Manager

JOB DESCRIPTION

Key Objective:

This role focuses on the technical handling of Auto, Property, General Liability, and Professional Liability claims across multiple jurisdictions.

The position is responsible for managing all aspects of claims, including investigation, coverage determination, reserving, negotiation, settlement, and overall claim strategy.

Travel may be required.

The role also involves representing the company at meetings with management, business partners, and other claim-related activities.

Major Duties & Responsibilities:


* Receive assignments and review claim and policy information to provide context for investigations; determine the extent of policy obligations based on the line of business, under close supervision.


* Supervise claim representatives in the handling of claims for assigned accounts.


* Review insurance policies to confirm coverage and ensure timely reporting to applicable primary, excess, or reinsurers.


* Maintain a diary system to ensure each file is reviewed at least every 90 days.


* Attend monthly and/or quarterly claims committee meetings, presenting cases in detail to support informed client decisions regarding strategy and reserving.


* Apply company-approved best practices to each file for timely and effective claims management; ensure each file includes a completed case strategy summary and disposition plan.


* Monitor defense counsel to ensure compliance with reporting requirements from clients and ESIS Specialty.


* Contact, interview, and obtain statements from insured parties, claimants, witnesses, medical professionals, attorneys, police officers, and others to secure necessary claim information.


* Prepare reports on investigations, settlements, claim denials, and evaluations of involved parties.


* Set reserves within authority limits and recommend reserve changes to the Team Leader and client.


* Review and process defense counsel and third-party invoices promptly to ensure timely payment.


* Review claim progress and status with the Team Leader, discussing challenges and recommending solutions.


* Settle claims promptly and equitably.


* Obtain releases, proofs of loss, or compensation agreements and issue payments for claims.


* Inform claimants, insured parties, or attorneys of claim denials when applicable.


* Assist the marketing team as new opportunities arise.

QUALIFICATIONS



* Minimum of 10 years of experience as a claims professional, including prior claims supervision, with advanced technical expertise in managing high-exposure claims and hands-on file and litigation management.


* Possession of a valid P&C insurance adjuster license is required.


* Experience in Professional Liability (PL), Auto Liability (AL), General Liability (GL), and Property claims.


* In-depth knowledge of insurance industry concepts, claims handling practices, and procedures.


* Proven ability to address significant co...