Casualty Claims Attorney

Casualty Claims Attorney :

A Claims Attorney specializes in managing insurance claims and disputes, with expertise in reviewing insurance policies, contracts, and related documents to assess coverage, liability, and damages. This role requires strong negotiation skills and a focus on resolving claims efficiently. The Claims Attorney does not represent the insured or the company in legal proceedings but plays a crucial role in evaluating and facilitating the resolution of claims.

Skills / Abilities :

• Investigate, evaluate and resolve non-litigated and litigated casualty claims in accordance with company policies and procedures.
• Review and analyze insurance policies, contracts, and other documents to determine coverage. Write and issue appropriate coverage letters, with input and approval from management and / or coverage counsel.
• Conduct timely and thorough investigations either directly or by use of an independent adjuster, gather evidence and prepare reports in support of claim decisions.
• Analyze and determine liability, damages and value of the claim.
• Exercise independent decision making with minimal supervision, using knowledge of applicable codes, laws, standards and regulations.
• Analyze and timely establish appropriate reserves for both loss and expenses and adjust reserves timely as needed.
• Assign appropriate counsel for the defense of the insured, when needed, and work collaboratively with assigned counsel to establish a budget and a strategy for management of the claim.
• Negotiate with claimants, their counsel or other carriers to reach an appropriate resolution of the claim.
• Attend court procedures, including hearings, mediations or trials as needed.
• Resolve claims through negotiation, mediation or trial.
• Identify and report all suspected fraud to internal or external SIU experts.
• Abide by all state claim handling regulations and best practices.
• Obtain all closing documents and close claim file.
• Respond to insureds and third parties promptly, courteously and professionally.
• Communicate the status of claims to insureds in a timely manner and work to resolve problems or concerns as they arise.
• Maintain accurate and complete claim files, ensure information is current and manage diaries / activities for assigned claims.
• Keep management and the underwriting department apprised of developments and emerging trends.
• Handle special projects as assigned.

Qualifications and Educational Requirements :

J-18808-Ljbffr