Claims Examiner

This role requires at least 4 days onsite per week.

The ideal claims team member will be an analytical and creative problem solver with the ability to hone in on key issues for coverage, liability and damage evaluation. Our claim examiners are assertive decision makers with a strong desire to persuade through negotiation and conflict management. The claims team offers on-going challenges, even for the most experienced professional, as every claim is unique, providing new opportunities to learn and grow. We welcome our ongoing interaction with underwriting, compliance, and actuarial to keep our products healthy.

Essential Functions:

Examiners are responsible for confirming coverage by reviewing the first notice of loss and policy information. Examiners prepare coverage position letters such as disclaimers and reservation of rights. Once coverage is confirmed, the examiner conducts a thorough and focused investigation of the claim to assess liability and damages. Examiners must understand and apply statutory and case law to assess liability exposure. Examiners should identify joint tortfeasors and ensure all parties pay their fair share. Examiners are responsible for maintaining adequate reserves as the claim develops to properly reflect ultimate exposure based upon liability and damage evaluation. Examiners are responsible for proactive file management toward final disposition via an effective diary, directly negotiating claims with a claimant or claimant attorney, overseeing defense counsel to ensure effective litigation management with established guidelines and reviewing/approving settlement agreements. Examiners must maintain substantive file notes that document all relevant claim activity. Examiners are responsible for preparing comprehensive and concise reserve authority requests, reinsurance reports, serious loss reports, coverage position letters as well as reports to underwriting and other departments.

Other Duties and Responsibilities:

In addition to the essential functions, an examiner is expected to support customer service by responding the same day to phone and email both internally and externally and adhere to established claim service promises. The position may entail completion of special projects. There is an expectation for enrollment in continuing education to maintain state licenses and to support both professional and personal development as outlined in the annual Individual Development Plan. Occasional travel required, i.e., attendance at mediation or court hearings.

Specific Skills:

Understanding of legal concepts, litigation processes and agency filings. Strong oral and written communication skills, insightful analytical skills, effective negotiation skills, strong organizational and time management skills, technical knowledge of insurance coverage, employment law, and claim evaluation.

Minimum Job Requirements

We are seeking 2+ years (Associate Claim Examiner) or 7+ years (Claim Examiner) of relevant experience handling liability matters including prior examiner, adjuster, paralegal, attorney/lawyer and/or other transferable experience. Employment practices, D&O and or E&O claim experience, multi-jurisdictional knowledge, advanced degrees and/or JD are a plus.

Passion and drive can be just as important as experience. If you’re excited about this opportunity, we’d love to hear from you!

At USLI, we are committed to fostering a vibrant and inclusive community that celebrates the rich diversity of all ethnicities, nationalities, abilities, genders, gender identities, sexual orientations, ages, religions, socioeconomic backgrounds, and life experiences. We understand the importance of continuous learning, self-reflection, acknowledging our biases, and expanding our perspectives beyond our own. We actively encourage open dialogue on diversity, equity, inclusion, and belonging to support a workplace where every individual feels valued, respected, and empowered to contribute at their fullest potential. Join us in building a diverse and inclusive environment where our shared values drive us toward excellence.

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Health insurance
• Paid time off
• Professional development assistance
• Referral program
• Tuition reimbursement
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Work Location: In person