Multi-Line Claims Adjuster

  • The Carlisle Group
  • Wilmington, DE, United States

Job Description

Multi-Line Claims Adjuster

Our client has Retained The Carlisle Group to conduct a Search for a Multi-Line Adjuster in their Delaware office. This position will allow remote work 3 days a week.

Job Requirements:

Job Responsibilities Include:

  • Verify coverage
  • Assign new losses to independent adjusters.
  • Review independent adjuster reports, bills and fee schedule through Imaging. Determine investigation needed, evaluate information to adjust reserves or settle claims.
  • Flag to Underwriting Department for adverse risk information.
  • Request payments - losses and expenses.
  • Process reserve changes.
  • Request public adjuster licenses and retainers.
  • Maintain current diary in Imaging on all files and request NJ Unfair Claims letter as appropriate.
  • Answer insured and Agent inquiries for status and coverage.
  • Issue coverage denials with manager approval, non-waivers or Reservation of Rights letters and all other written correspondence as appropriate.
  • Issue statute to file suit letters.
  • Comply with NJ Unfair Claims Act and Claims Ombudsman standards.
  • Maintain adjuster, expert and attorney lists.
  • Notify reinsurers of property and liability treaties, reserves and payments.
  • In House Claims
  • Send out appropriate forms.
  • Review documentation.
  • Set and update reserves as needed.
  • Work with replacement companies.
  • File CIB and Section 111 info, or PILR.
  • Take recorded statements as appropriate.
  • Finalize settlements with appropriate documents.
  • Request settlement checks.
  • Have professional telephone skills.
  • Handle claims through Imaging Workflow including diary, mail review and 1st Reports.
  • Import adjuster reports and subro attorney reports received via e-mail into Imaging System.
  • Keep abreast of any trends in claims that impact handling.
  • Handle 1st party litigation filed by our insureds. Work with attorneys for EUO and Subro. Monitor case and participate in discovery and decision making. Knowledge of NJ Court System.
  • Identify subrogation potential and utilize property inter-company arbitration to resolve claims in all subro cases where applicable.
  • Handle 3rd party files in litigation. Monitor case and participate in discovery and decision making. Knowledge of NJ Court System, comparative negligence and Title 59.
  • Be able to evaluate medical specials, lost wages and liability in order to negotiate and settle claims.
  • Knowledge of building and medical terminology.
  • Complete Claims Education courses as outlined in your yearly goals.
  • Deliver timely, quality customer service in all aspects of job position.
  • Others jobs as assigned.

Education or Equivalent Job Experience:

  • College Degree or 1-3 years insurance related exposure and/or insurance courses required.

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