General Liability Major Case Specialist

* Directly handle assigned severe claims.
* Full damage value for average claim (without regard to coverage or liability defenses): $500,000 to several million dollars, amounting to a typical inventory of claims with FDV of over a multi-million dollar value.
* Provide quality customer service and ensure file quality, timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case.
* Work with Manager on use of Claim Coverage Counsel as needed.
* Directly investigate each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential.
* Interview witnesses and stakeholders; take necessary statements, as strategically appropriate.
* Complete outside investigation as needed per case specifics.
* Actively engage in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants nurse consultants, and fire or fraud investigators, and other experts.
* Verify the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation.
* Maintain claim files and document claim file activities in accordance with established procedures.
* Develop and employ creative resolution strategies.
* Responsible for prompt and proper disposition of all claims within delegated authority.
* Negotiate disposition of claims with insureds and claimants or their legal representatives.
* Recognize and implement alternate means of resolution.
* Manages litigated claims. Develop litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers.
* Utilize evaluation documentation tools in accordance with department guidelines.
* Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis.
* Utilize diary management system to ensure that all claims are handled timely. At required time intervals, evaluate liability and damages exposure.
* Establish and maintain proper indemnity and expense reserves.
* Provide guidance to underwriting business partners with respect to accuracy and adequacy of, and potential future changes to, loss reserves on assigned claims.
* Recommend appropriate cases for discussion at roundtable.
* Attend and/or present at round tables/ authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expense.
* Actively and enthusiastically share experience and knowledge of creative resolution techniques to improve the claim results of others.
* Apply the Company's claim quality management protocols, and metrics to all claims; document the rationale for any departure from applicable protocols and metrics with or without assistance.
* Apply litigation management through the selection of counsel, evaluation.
* Perform other duties as assigned.
* Bachelor's Degree.
* 10+ years claim handling experience with 5-7 years experience handling serious injury and complex liability claims.
* Extensive working level knowledge and skill in various business line products.
* Excellent negotiation and customer service skills.
* Advanced skills in coverage, liability and damages analysis with expert understanding of the litigation process in both state and federal courts, including relevant case and statutory law and procedure; expert litigation management skills.
* Extensive claim and/or legal experience and thus the technical expertise to evaluate severe and complex claims.
* Able to make independent decisions on most assigned cases without involvement of supervisor.
* Openness to the ideas and expertise of others and actively solicits input and shares ideas.
* Thorough understanding of commercial lines products, policy language, exclusions, ISO forms and effective claims handling practices.
* Demonstrated strong…