Senior Property Claims Adjuster - Field
EMC InsuranceAbout the role
At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together.
**This position is eligible to work remotely in the Minneapolis/St Paul, Minnesota area**
Exercises independent judgment in the investigation, evaluations, negotiation, and disposition of large and moderately complex to complex commercial property claims, including claims in litigation, within limitations of authority outlined in the Claims Guide. Communicates with insureds, agents, and experts regarding coverage and claim status or questions.
Essential Functions:
1. Promptly investigates and evaluates large and moderately complex to complex commercial property claims and reinsured cyber claims as assigned:
Reviews and evaluates the claim notice, lawsuits, contracts, and policies to verify coverage, deductibles, claim payee/mortgagees and determines compensability
Performs field inspections on large and moderately complex to complex commercial property claims as applicable
Initiates timely contact with insureds and claimants to explain the claims process
Coordinates with appropriate experts to ensure urgent matters are addressed, such as initial remediation, temporary restoration, business continuation either at the damaged location or at a new temporary business site, preserving evidence, securing origin and cause experts, various engineers, general and subcontractors etc., and multi-party reinspection
Obtains statements from insureds, claimants, witnesses, and all other pertinent parties
Documents claim activities, reserve analysis, summaries of reports in the claim system
Sets timely, adequate reserves using reserve worksheets in compliance with the company reserving philosophy and methodology
Analyzes business records, such as profit and loss statements, tax forms, financial forecasts, and payroll records to estimate the loss of business income
Secures all necessary official reports, claim forms, and pertinent documents
Reviews bills, invoices, and receipts, including legal and litigation related expenses, for accuracy and appropriateness
Notifies all parties involved that legally require appropriate notice
Notifies the Claims Supervisor of claims exceeding authority level and requiring assignment to more senior level team member
2. Negotiates, settles and/or resolves large and moderately complex to complex commercial property claims:
Resolves questions of coverage and resolves disputes on repair methods and the value of the claims
Drafts and sends reservation of rights and denial letters upon manager approval
Evaluates cause of loss and writes detailed estimates for cost of repairs and value of damaged property, including reviewing discrepancies identified between research and software estimates
Provides prompt, detailed responses to agents, insureds, and claimants on the status of claims
Evaluates, analyzes negotiation ranges, and target settlement numbers
Communicates with insureds/claimants/attorneys to negotiate the settlement of claims
Performs re-inspection of property files and participates as an adjuster or re-inspector during catastrophic claims operations
Identifies, investigates, and proactively pursues opportunities for recovery, including arranging of evidence preservation in legal compliance that meets custody, control, transfer, analysis, and disposition of physical and/or electronic evidence
Recommends appropriate defense counsel to manager and collaborates with assigned attorney on litigation following EMC case handling guidelines
Identifies potential fraudulent claims and refers cases to Special Investigation Unit (SIU) as necessary, participating in any subsequent subrogation and SIU proceedings
Drafts and issues settlement documents and timely payments, including statements of loss and proof of loss, and verifies accuracy and compliant documentation
Assists as needed in the coordination and preparation of cases involved in mediations, appraisals, arbitrations, and lawsuits
3. Collaboration
Submits referrals to the Estimatics, SIU, Large Loss Claims, Bond, Subrogation, and Coverage Counsel when necessary
Prepares risk reports for Underwriting and Risk Improvement
Review coverage intent and policy activity with Underwriti
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