Financial Lines Claims Adjusternew

The Finacial Lines Claims Adjuster is responsible to manage a mixture of Financial Institutions (FI), Errors & Omissions (E&O), Employment Practices Liability (EPL), Cyber Liability, Environmental Liability and Directors & Officers claims (D&O), from notification to resolution of claims, including coverage analysis, legal liability, quantum analysis, reserving, communication, documentation, litigation management, evaluation, coverage allocation, negotiation and settlement. 

• Exercise proper judgment and decision making to analyze the claims exposure to determine the course of action and negotiate and settle the claim with first and third party claimants, authorizing claims payments and reserves in accordance with policy provisions and applicable law to ensure service standards are maintained.

• Support the Claims Management team by providing quality claims handling and superior customer service ensuring that the claims function runs effectively as well as work closely with underwriters providing feedback on claims issues, wording and market trends.

• Ensure compliance with best practice for all aspects of claims assessment/handling including identify and review suspect/fraudulent claims on a consistent basis as well as actively promote and demonstrate principles of treating customers fairly.

• Work collaboratively with other business functions, brokers and external providers to develop and maintain effective relationships to gather technical information for the benefit of the claims function.

• Assist the Financial Lines Supervisor with larger and more complex claims when required.

• Liaise with external providers, monitoring the quality and costs of services provided to ensure that high service standards are met as well as foster good relationships with internal and external customers and drive excellent customer service.

• Proficient in insurance coverage knowledge and experience in litigation management of diverse civil procedures.

• Perform specials projects and other related duties as assigned.

• Bacherlor’s Degree in Business Administration or Finance.

• Juris Doctor & practicing experience attorney preferable. 

• Valid adjuster’s license issued by the PR Insurance Commissioner Office, preferable.

• Strong analytical decision making and problem-solving skills.

• Ability to plan, organize and prioritize while working in a constant changing environment. 

• Solid understanding of the claims legal process and quantum with knowledge of the Civil Procedure Rules.

• Demonstrate flexibility and adaptability to work in a fast moving and challenging environment.

• Proficient in MS (Word, Excel and Power Point). Strong skills of database applications related to claims services.

• Advanced knowledge of the structure and content of the English and Spanish Language.

• Two (2) to three (3) years of previous experience in all major aspects of the claims adjustments process in Financial Lines, preferable.