Senior Complex Claims Specialist II
Berkley, Las Vegas, NV, United States
Company Details
Vela Insurance Services provides specialized Excess and Surplus Lines Casualty and Professional Liability insurance solutions in the following four market segments.: Construction, Specialty Casualty, Velocity Smal Business & Professional Liability. We offer national service and local knowledge to our exclusive wholesale broker network and the businesses they serve.
The Company is an equal employment opportunity employer.
https://www.vela-ins.com/
Responsibilities
Must be capable of working under limited supervision and working with a remote manager and colleagues in other locales. In this role, the claims professional investigates, evaluates, negotiates, and resolves complex litigated and non-litigated construction defect property damage and claims of high exposure and complexity. The role requires significant experience and a focus on specialized claims in the area of construction defect involving complex coverage issues.
- Analyze coverage, identify coverage issues, and draft coverage letters for supervisor approval.
- Investigate and evaluate liability.
- Investigate and evaluate damages.
- Manage litigation by assigning counsel from the approved panel where applicable, establish litigation plan and budget, coordinate with defense counsel, and continuously review the potential for resolution.
- Establish timely reserves within authority and re-evaluate throughout the life of the claim.
- Maintain up-to-date, appropriate file documentation and written file notes.
- Maintain an active diary and productive file inventory.
- Timely completion of all required large loss reporting.
- Negotiate settlements within authority limit granted, and attend mediations, Mandatory Settlement Conferences, and/or Alternative Dispute Resolutions.
- Proactively control the work product and expense of outside vendors.
- Develop and maintain positive customer relationships and provide superior customer service.
- Timely identify all potential opportunities for co-insurance, transfer of risk and/or subrogation.
- Ability to Work with designated assigned accounts.
- Recognize and investigate fraud.
- Comply with deductible/self-insured retention recovery protocol.
- Meet and maintain all State licensing requirements at all times (see qualifications below).
- Adhere to all statutory regulations, Unfair Claims Practices acts, and corporate Best Practices.
- Serve as mentor for claims associates; provide technical advice.
- Assist management with administrative tasks as needed.
- Regular and predictable attendance.
- Other duties as assigned.
Qualifications
- Four (4) year College Degree, or commensurate experience and training.
- JD preferred, but not required.
- AIC, SCLA, CRIS or other similar industry designations preferred.
- Ten (10) or more years claims handling experience or equivalent experience.
- In-depth knowledge of the insurance industry, including legal and regulatory environments.
- Ability to travel, as required. (Generally, less than 15%.)
- A strong functional and developing knowledge of substantive laws and legal procedures.
- Applicable adjusters license(s) to include CA, CT, DE, FL, KY, LA, NH, NM, NC, OK, RI, SC, TX, VT, WV, WY
#LI-FL1 #LI-HYBRID