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Liability Claims Examiner in Clearwater, FL at Heritage Insurance

Date Posted: 5/7/2018

Job Snapshot

Job Description

Position Summary:

The Liability Claims Examiner provides prompt, courteous and fair claim service on homeowners and commercial liability property damage and bodily injury claims from initial claim set up through claim resolution.




  • Makes timely initial contact and appropriate follow up contact with all relevant parties to provide explanation of claim process, set expectations, gather facts and provide information on developments.
  • Performs and documents initial coverage analysis and recognizes potential coverage issues
  • Conducts, directs and/or oversees the development of facts necessary to address coverage, liability and damage aspects of the claim
  • Evaluates facts to properly analyze applicable coverage issues
  • Drafts coverage letters including declinations, reservation of rights, excess and partial denials
  • Applies relevant jurisdictional laws and uses independent judgement to reach liability determinations based upon the facts
  • Gathers appropriate supporting damage documentation and evaluates amounts owed based upon analysis of coverage, liability and relevant jurisdictional laws
  • Effectively communicates claim decisions verbally and in writing to policyholders, claimants, attorneys and agents
  • Properly updates claim file with key activities and documents
  • Maintains effective diary system to bring claims to timely resolution
  • Communicates effectively with internal business partners including Customer Service and Underwriting
  • Develops constructive relationships and works effectively with outside vendors such as independent adjusters and defense counsel
  • Establish appropriate reserves based upon competent analysis of coverage, liability and damages and adjust reserves as necessary in a timely manner upon receipt of additional relevant information.
  • Apply common sense and cost-benefit analysis to claim decisions
  • Complete necessary claim reporting to management including high exposure alert notifications
  • Evaluates and resolves liability claims within scope of authority
  • Conducts Medicaid/Medicare reporting in accordance with federal law
  • Reviews invoices for accuracy and completes timely expense and indemnity disbursements assuring compliance with tax reporting requirements
  • Oversees handling of cases in litigation and provides appropriate guidance to defense counsel
  • Attends and actively participates in mediations and other forms of alternate dispute resolution where required by the court or where appropriate to move the claim to a timely and proper resolution
  • Recognizes potential third party tortfeasors and develops facts to support the likeliness of successful recovery
  • Prepares appropriate claim updates for management and excess carriers
  • Participates in claims reviews presents issues and recommendations in a precise and understandable manner






Job Requirements


  • Exceptional customer service skills
  • Emotional intelligence and ability to manage conflict
  • Advanced analytical, problem-solving and decision making skills
  • Ability to communicate effectively verbally and in writing with varying audiences
  • Excellent negotiation skills and track record of proven results
  • Team-player who is comfortable working in a dynamic, entrepreneurial environment
  • Willingness to simultaneously work on multiple projects and fulfill multiple roles
  • Proven leadership and mentoring capabilities
  • Ability to interpret a variety of policy forms and endorsements
  • History of litigation claims management and working effectively with defense counsel
  • Familiarity with reading and interpreting contracts, statutes and case law




  • Bachelor’s degree or higher
  • 7 years liability claim handling experience (multi-jurisdiction preferred)
  • 5 years bodily injury evaluation and negotiation experience (serious injury preferred)
  • General Commercial Liability experience preferred
  • Licensed to adjust claims in Florida (multi-state licensing preferred)
  • Strong computer skills and advanced knowledge of Microsoft products