Lead Sr. Casualty Claims Adjuster

General Liability


John Ruiz

Los Angeles

A+ rated national insurance carrier bringing claims back in-house from a TPA, building their internal P&C / general liability, injury, CD and property claims department.
Potentially a unique opportunity to be one of the initial hires, involved and provide input into the operation of a new claims operation.
Analyze, confirm/deny commercial lines coverage, investigate liability & damages, set and adjust reserves, negotiate and resolve litigated and some non-litigated nationwide casualty claims, emphasis on construction industry and other industry books of business including general liability, product liability, transportation and equipment bodily injury claims. Establish coverage positions relative to policy, laws and the industry. Flexibility to initiate, be creative and think outside of the box in claims handling / resolution.
Proactively conduct coverage and claim investigations, handle complex claims to resolution. Analyze and draft coverage letters, communicate coverage positions to insureds, brokers and agents. Assimilate all transfer cases and keep files current, apply Best Practices, adhere to company internal guidelines and procedures. Maintain a 1-1 open to close ratio, control / reduce average indemnity and ALE. Direct and closely monitor defense counsel, legal and other expenses, outside vendors / experts as needed, draft reports, set and adjust reserves within granted authority. Interact closely with claims leadership and underwriting involving complex issues. Attend conferences, mediations and trials as necessary. May also assist in mentoring less experienced adjusters.
These were generally in-office positions, but as of now remote indefinitely, potential option of in-office and / or remote in the future (TBD).
Seven plus years of in-depth general liability and bodily injury experience, multi-state preferred (some New York Labor Law claims experience helpful). Proficient in coverage analysis, directing litigation including legal budgets, costs / expense control, risk transfer and recovery, utilize strong communication, analytical, decision-making and problem-solving skills.
Bachelor's degree or the equivalent professional experience preferred.
Possess or attain State Adjusting Licenses where required.
Proficiency using Microsoft Office (Excel, Access, PowerPoint, Word).
Travel Percentage: maybe up to 30%.
Salary: Open, DOE and current compensation level; excellent benefits

The Claims Education Panel wishes to thank the dedicated insurance professionals and service providers who have given their valuable time and expertise in providing the insurance industry with a much needed and valuable resource.

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Claims Education Panel is a service mark of Ruiz & Associates, Inc.