Job Description

Position Summary

The Property Claims Examiner is responsible for adjusting and/or managing independent adjusters with investigating, negotiating, and settling property insurance claims within designated authority limits. This role requires in-depth analysis of property losses, identification of risks such as arson or fraud, and efficient handling of claims in litigation. The examiner ensures compliance with company policies, manages claim assignments to independent adjusters, and maintains strong relationships with agents and third-party vendors while adhering to industry standards and regulatory requirements. While the primary responsibility is handling property claims, this position may also require or offer opportunities to handle claims in other lines, such as casualty or automobile. This allows the candidate to expand their expertise and support the broader needs of the claims department as necessary.

Principal Accountabilities

Planning and Delivery

• Investigates property claims, ensuring a thorough review of facts, policy terms, and conditions to determine coverage.
• Manages claim assignments to independent adjusters, appraisers, and vendors while monitoring quality and cost control.
• Evaluates large-loss exposures, prepares detailed settlement recommendations, and files large-loss reports as needed.
• Ensures timely claims settlement, maintaining proper reserves and documenting files accurately.

Business Insight and Analytics

• Identifies and evaluates potential arson, fraud, or high-risk claims and coordinates with legal and underwriting teams as needed.
• Reviews and assesses trends in claims data to identify risk factors and recommend process improvements.
• Provide input to leadership on claim patterns, emerging risks, and mitigation strategies.

Communication and Relationship Building

• Maintains positive relationships with agents, ensuring excellent customer service and risk management communication.
• Works closely with policyholders, witnesses, and independent adjusters to obtain statements of loss and necessary documentation.
• Collaborates with legal counsel and other internal departments on claims in litigation or involving coverage disputes.

Leadership

• Mentors and trains junior claims staff on handling complex claims and identifying potential risks.
• Participates in professional development activities, including seminars and workshops, to stay current on industry trends.
• Assists in refining claims department procedures and policies for operational excellence.

Job Requirements

Experience

• Minimum of 5 years of experience in property claims, including large-loss claims and litigation exposure.
• Proficiency in handling suspicious and fraud investigations and working with independent adjusters and appraisers.

Education

• Bachelor’s degree in business, insurance, or a related field; equivalent work experience may be considered.
• Completion of professional certifications (e.g., AIC, CPCU) is highly desirable.

Skills

• Strong negotiation skills, with the ability to settle claims effectively within authority limits.
• Excellent analytical skills for evaluating damage, determining liability, and assessing reserves.
• Proficient in verbal and written communication, with a focus on customer service and agent relationships.
• Solid knowledge of property insurance policies, exclusions, endorsements, and related legal principles.
• Proficient with coverage analysis and constructing reservation of rights and coverage denial letters.

Values

• Demonstrates integrity, fairness, and empathy in all aspects of claims handling.
• Committed to continuous learning and professional development to stay ahead in a dynamic industry.
• Maintains a team-oriented mindset and collaborates effectively across functions.

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