[Hiring] Commercial Claims Examiner III @California FAIR Plan Association

Role Description

The Commercial Property Examiner reviews, evaluates and processes complex commercial insurance claims and makes recommendations for resolution. Additionally, this role will examine and authorize commercial insurance claims investigated by independent adjusters. Lastly, the commercial property examiner will review claim forms and other records to determine insurance coverage, ensuring payment recommendations and settlements have been made correctly.

• Manage a caseload of commercial property claims from assignment through resolution.
• Examine commercial claims investigated by independent adjusters to determine the extent of insurance coverage and validity of the claims.
• Review and adjust commercial loss reserves, correspondence, reports, verify coverage and authorize payments submitted by independent adjusters.
• Collaborate with internal personnel and/or legal counsel on claims involving litigation.
• Investigate, evaluate, and adjust claims, applying technical knowledge and human relations skills to promote fair and prompt settlement of claims.
• Oversee independent adjuster files to ensure they have followed CFP IA Guidelines.
• Verify and analyze data used in settling claims to ensure validity and that settlement is in accordance with company practices and procedures.
• Maintain compliance with the Department of Insurance and Company procedures.
• Identify fraud or illegal activity indicators and follow internal processes to refer the claims to the appropriate personnel for follow up.
• Promptly negotiates settlements ensuring the settlement reflects the insured losses while confirming the insurer is protected from invalid claims.

Qualifications

• Bachelor’s degree or equivalent.
• 5+ years of property claims adjusting experience, including 2+ years commercial property claims preferred.
• Excellent oral and written communication skills.
• Working experience with MS-Office (especially Word and Excel).
• Comprehensive understanding of policy contract/statutes and claims processes.
• Certified in CEA and Fair Claims Settlement Practices.
• 4 years Commercial Experience, 2 years claims over $500k.

Company Description