We are seeking an experienced Senior Casualty Examiner specializing in construction defect claims to manage complex liability cases and deliver effective, well-supported claim resolutions. In this role, you will oversee the claims lifecycle, from initial investigation and coverage analysis to litigation management, settlement negotiations, and final resolution. You will evaluate liability exposures, establish appropriate financial reserves, and collaborate with insurers, legal counsel, experts, and other stakeholders to develop sound resolution strategies. You will also ensure compliance with applicable insurance regulations while maintaining accurate documentation and providing clear, timely communications. Working in a remote or hybrid environment, you will exercise independent judgment in handling complex claims and contribute your expertise to underwriting and other business partners. This opportunity is ideal for a seasoned claims professional with specialized construction defect experience, strong analytical skills, and a commitment to achieving fair and financially responsible outcomes.
- Claims Investigation and Evaluation: Manage construction defect claims and selected third-party property damage claims, conducting thorough investigations to establish liability, assess damages, evaluate exposure, and determine appropriate resolution strategies.
- Coverage Analysis: Review insurance policies, assess applicable coverage, identify potential coverage issues, and prepare clear, well-supported coverage position letters when necessary.
- Claims Resolution and Negotiation: Develop and execute effective strategies to resolve claims through negotiation, mediation, settlement conferences, or litigation, balancing legal considerations, financial exposure, and business objectives.
- Co-Carrier Coordination: Collaborate with other insurers and co-carriers to reach agreement on time-on-risk allocations, case valuations, liability assessments, and appropriate resolution approaches.
- Litigation Management: Select and coordinate defense counsel for litigated cases, maintain regular communication with legal representatives, and establish mutually agreed litigation plans, legal budgets, and case management strategies.
- Expert Engagement: Coordinate the selection and retention of technical experts and other specialists as needed, ensuring that engagements align with approved budgets and claim objectives.
- Reserving and Financial Exposure: Establish timely and accurate indemnity and expense reserves based on documented exposure assessments. Review reserve adequacy throughout the claims lifecycle and adjust estimates as circumstances evolve.
- Authority Requests and Reporting: Prepare and submit authority requests for cases exceeding delegated approval limits. Develop comprehensive reports covering critical issues, exposure assessments, supporting rationale, and proposed resolution strategies, and present cases during verbal roundtables or conference calls.
- Regulatory Compliance: Ensure claims handling activities comply with applicable state Department of Insurance (DOI) regulations, licensing requirements, internal procedures, and relevant legal standards.
- Mediations, Settlements, and Trials: Travel when necessary to attend mediations, settlement conferences, trials, and other proceedings involving complex or high-exposure claims.
- Industry and Legal Developments: Stay informed about changes in case law, construction defect litigation trends, insurance regulations, and claims management practices to support sound decision-making.
- Cross-Functional Collaboration: Partner with underwriting teams and other business stakeholders to share claims insights, address emerging risks, and support informed business decisions.
- Documentation and Communication: Maintain complete, accurate, and well-organized claim files while communicating effectively with claimants, insured parties, legal counsel, co-carriers, and internal stakeholders.
Requirements:
- Education: Bachelor's degree or equivalent relevant professional experience.
- Claims Experience: Significant experience in insurance claims handling, with at least five years of claims handling experience required and a preference for ten or more years of overall claims experience.
- Construction Defect Expertise: At least three years of hands-on construction defect claims handling experience, with substantial knowledge of construction-related liability exposures, defect allegations, damages, and resolution strategies. Five or more years of construction defect experience is desirable based on the original role profile.
- Casualty Claims Management: Demonstrated ability to manage complex casualty claims independently, from initial investigation and coverage evaluation through litigation, negotiation, and resolution.
- Coverage and Liability Analysis: Strong knowledge of insurance policy interpretation, coverage assessment, liability investigation, damages evaluation, and the preparation of coverage position letters.
- Litigation and Settlement Experience: Experience coordinating defense counsel, managing litigation budgets, retaining experts, participating in settlement negotiations, and developing effective strategies for resolving complex claims.
- Financial and Analytical Skills: Ability to assess claim exposure, establish appropriate reserves, evaluate financial risks, and prepare detailed reports supporting settlement recommendations and authority requests.
- Licensing: Must hold, or be able to obtain, the required claims licenses in all applicable states.
- Professional Designations: Industry credentials such as Chartered Property Casualty Underwriter (CPCU), Associate in Claims (AIC), or Senior Claim Law Associate (SCLA) are advantageous.
- Regulatory Knowledge: Familiarity with applicable insurance regulations, Department of Insurance requirements, claims documentation standards, and relevant case law.
- Communication and Negotiation: Excellent written and verbal communication skills, with the ability to explain complex claim issues, negotiate effectively, and present recommendations confidently to internal and external stakeholders.
- Organization and Time Management: Strong attention to detail and the ability to prioritize multiple complex claims, manage deadlines, maintain accurate records, and respond promptly to changing circumstances.
- Independent Judgment: Sound decision-making skills, professional integrity, and the ability to manage sensitive, high-exposure claims while balancing legal, financial, and business considerations.
- Collaboration and Adaptability: Ability to work effectively with attorneys, insurers, underwriting teams, experts, and other partners in a remote or hybrid environment.
- Travel Flexibility: Willingness to travel as required for mediations, settlement conferences, trials, and other claim-related proceedings.
Benefits:
- Competitive Salary: Annual salary range of $120,000–$140,000, depending on experience, qualifications, and other applicable factors.
- Remote or Hybrid Work: Flexibility to work remotely or within a hybrid arrangement, depending on role requirements.
- Comprehensive Healthcare Coverage: Medical, dental, and vision insurance options.
- Unlimited Paid Time Off: An unlimited PTO policy designed to support flexibility and personal wellbeing.
- Retirement Benefits: 401(k) retirement savings plan with employer matching contributions.
- Wellbeing Programs: Access to a variety of employee wellbeing resources and initiatives.
- Paid Volunteer Days: Opportunities to contribute to community initiatives through paid volunteer time.
- Professional Development: Opportunities to expand insurance claims expertise, stay current with industry developments, and contribute to evolving claims practices.
- Collaborative Work Culture: An environment that encourages new ideas, recognizes individual contributions, and supports meaningful participation in business success.
- Inclusive Workplace: A commitment to equal employment opportunities, fair treatment, accessibility, and reasonable accommodations throughout the recruitment and employment process.
