Job Summary
The Complex Claims Master Adjuster works within highest limits and authority on
highly complex claim assignments. The role is responsible for the appropriate
resolution of complex claims representing the highest levels of exposure and
expense to the organization. The role determines coverage, investigates,
analyzes, negotiates, and settles the highest and most complex claims with high
corporate visibility and/or significant exposure. The role also empowers and
leads claims adjusters to achieve claims management excellence, directly handles
the largest and most complex claims, serving as a technical consultant and
subject matter expert to business partners.
Job Responsibilities
Determines whether coverage exists for the type of complex claim assigned and
investigates thoroughly to obtain relevant facts concerning all aspects of
the claim, such as coverage, liability, legal climate, potential exposure,
and damages, and makes decisions, where appropriate, on claim resolution.
Selects, directs, and supervises internal and external resources and experts
impacting short and long-term claim results.
Maintains effective and ongoing communication with claims staff, internal and
external business partners, insureds, claimants, agents, attorneys, other
insurance companies, claims leadership, vendors/contractors, and public
adjusters.
Establishes and reviews proper reserves for each claim based upon thorough
investigation, evaluation, and experience and completes appropriate reports
so that the status of the claim is clearly always documented.
Negotiates timely and appropriate settlements with insureds, claimants,
vendors, attorneys, and other insurance companies and refers claims exceeding
authority to appropriate leader with recommendations.
Remains current on industry topics, trends, processes, technology, best
practices through research, industry events, networking, etc.
Assists less experienced claims professionals in the handling of large or
complicated losses and actively participates in the coaching, development,
training, and education of claims professionals.
Participates in large/complex exposure file analysis and strategy development
via roundtable discussions.
Travels as often as needed including regular utilization of assigned fleet
vehicle to cover assigned territory. May involve traveling on short notice or
other daily driving duties as assigned regardless of location.
Job Qualifications
10+ years of Complex Claims handling experience.
Bachelor's degree in Business Administration or related field and/or
commensurate work experience.
Valid driver’s license and a driving record that conforms to company
standards.
Location
Remote
Licenses and Certifications
Chartered Property Casualty Underwriter (CPCU) (Preferred)
Associate in Claims (AIC) (Preferred)
Behavioral Competencies
Collaborates
Communicates Effectively
Customer Focus
Decision Quality
Nimble Learning
Technical Skills
Claims Adjustment
Claims Evaluation
Claims Investigation
Claims Management System
Insurance Industry Knowledge
Business Process Improvement
Financial controls
Claims Case Management
Data Analysis and Reporting
Cost Optimization
This job description describes the general nature and level of work performed in
this role. It is not intended to be an exhaustive list of all duties, skills,
responsibilities, knowledge, etc. These may be subject to change and additional
functions may be assigned as needed by management.
Founded in 1848, Westfield is a global leader in property and casualty
insurance, delivering superior risk insights and innovative solutions to
customers through a diverse portfolio of insurance products. Westfield
underwrites commercial, personal, surety, and specialty lines of coverage
through a network of leading independent agents and brokers in the United States
and specialty products through Lloyd’s of London Syndicate 1200. As a mutual
insurance company with more than 3,000 employees, Westfield has revenues in
excess of $4 billion and more than $10 billion in assets.