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.