Our client have a fabulous new opportunity for a Senior Casualty Claims Adjuster. The role will be based in the London office and involves the examination, analysis, negotiation and settlement of Employers Liability, Public Liability and Product Liability claims from cradle to grave. 
 

The position will be actively involved in the negotiation of settlements, attending market meetings, and authorisation of claims. Therefore applicants must have good knowledge of the London and Lloyd’s insurance markets. The handler is required to assist in the development/training other colleagues to enhance their knowledge on Casualty claims and specific accounts and also to develop effective working relationships with brokers.  As well and adhering to all internally set Key Performance Indicators, the handler must comply with all regulatory requirements and with the Lloyd’s minimum standards.

Responsibilities include:

Examine claim data and underwriting documentation to ascertain validity of losses notified against cover provided and establish premium payment status for both the Company and Lloyd’s platforms. Be experienced and confident in the management of complex coverage issues and policy declinatures.

Assist with claim reviews and audits at the offices of Coverholders, ceding companies, TPAs and other Insurers and to report on their compliance or otherwise with terms and conditions of risks written and their overall claims handling service.

Establish adequate reserves in a timely fashion for the estimated amounts of anticipated loss and/or adjustment and coverage expenses. Ensure accurate recording of reserves on claims systems. Conduct regular reviews of the claim portfolio to assess the adequacy of reserves being carried. Demonstrate a comprehensive understanding of watchlist processes and recording of reserve volatility.

Demonstrate full control and oversight of all stakeholders in the claims process, including lawyers, loss adjusters, technical and medical experts. Be prepared to challenge advice and review evidence / recommendations critically.

Recognise contentious issues and, where appropriate, inform claims management to discuss legal obligations and/or remedies and take appropriate action.

Inform claims management for onward reporting of any large or unusual losses in order that financial exposure can be fully evaluated and future corrective measures can be determined. This includes the drafting of Large Loss Notices in a timely manner for distribution around the business and the maintaining and updating of the company Claims Watchlist.

Manage and monitor the performance of outsourced Coverholders and TPAs where appropriate to ensure that customers receive a good level of service from both our external and internal claims handlers. Conduct internal audits of TPAs to ensure technical compliance. Review and process complex claims referrals with speed and authority from TPA’s. Detect, and intervene when poor claims handling and strategy is noted.

Maintain accurate and presentable claims files, which contain all necessary documentary evidence, communications and files notes. Files will demonstrate ownership of claims strategy and reserve.

Experienced in the use of a range of London market claims systems.

Attend internal claim meetings, market meetings and seminars and to represent the company as and when required. When required, support management by preparing and supervising internal and external meetings, including team meetings and meetings with underwriters / brokers /  policyholders.

Provide ongoing mentoring and technical guidance to junior members of the team.

Desired Skills & Experience

This role requires a handler of previous experience in the insurance industry handling third party EL/PL/Product Liability claims. The candidate needs to:

• Be technically proficient and have a proven record of successfully handling primary and excess lead Casualty claims (i.e. EL/PL/Property Liability and Product Liability) in multiple jurisdictions.

• Have a proven track record of handling referrals of such claims from TPAs/Coverholders pursuant to outsourcing arrangements when the claims are referred to the company under the TPA/Coverholder’s delegated claims authority

• Have a good understanding of the insurance industry, particularly the London and Lloyd’s insurance markets and their claims systems (e.g. ECF2)