Claims Adjuster - General Liability

Position: Claims Adjuster - General Liability

Duration: 03 months of contract with possible extension or conversion

Location: 100% Remote role.

Required skills, certifications, and licenses:

• Commercial General Liability (CGL) claims handling experience
• TX and FL licenses with reciprocals required
• NY and AZ licenses preferred
• AIC and/or CPCU designations preferred

We are seeking adjusters with true commercial GL claims handling experience, preferably two or more years, who can make coverage decisions and have litigation experience.

Job Description:

Essential Functions and Responsibilities:

Claim Investigation & File Ownership

• Independently investigate and manage a full caseload of CGL claims, including but not limited to premises liability, slip and fall, product liability, construction defect and construction-related losses, and contractual liability exposures.
• Drive timely claim resolution through proactive file management, strategic planning, and adherence to best practices in diary management and documentation.

Coverage Analysis & Policy Interpretation

• Analyze complex policy language, including insuring agreements, endorsements, exclusions (e.g., ongoing/completed operations, additional insured provisions), and limits to determine coverage applicability.
• Draft clear, defensible coverage position letters, including reservation of rights and denial letters, consistent with jurisdictional requirements and client expectations.

Liability & Damages Evaluation

• Conduct comprehensive liability investigations, including: 
• Review and analysis of incident reports, contracts, lease agreements, and indemnification provisions
• Identification and application of contractual risk transfer provisions
• Obtaining and evaluating recorded statements, expert opinions, photographs, and surveillance
• Evaluate injury severity, medical treatment, and long-term exposure, including review of medical records, bills, and independent medical evaluations (IMEs) where applicable.
• Establish, maintain, and adjust reserves in accordance with claim developments and severity exposure.

Litigation Management

• Manage litigated files, including the retention and direction of defense counsel.
• Provide strategic oversight on litigation plans, budgets, pleadings, discovery, and dispositive motions.
• Participate in mediations, settlement conferences, and trial preparation, ensuring alignment with client and organizational strategies.

Settlement & Negotiation

• Negotiate settlements within delegated authority while balancing cost containment and risk exposure.
• Evaluate settlement value based on liability, damages, venue, and litigation risks, and escalate appropriately when exceeding authority.

Risk Transfer & Subrogation

• Identify, evaluate, and pursue risk transfer opportunities, including: 
• Additional insured tenders
• Contractual indemnity provisions
• Subrogation potential
• Coordinate with coverage counsel, carriers, and third parties to maximize recovery and proper allocation of liability.

Client & Stakeholder Communication

• Maintain proactive, professional communication with insureds, claimants, brokers, clients, and internal stakeholders.
• Provide detailed status updates, large loss reports, and claim summaries tailored to client-specific reporting requirements.

Documentation, Compliance & Quality

• Maintain thorough, accurate, and timely file documentation to support claim decisions and audit readiness.
• Ensure compliance with applicable state regulations, client service instructions, and internal audit and quality standards.
• Participate in internal and external audits, file reviews, and continuous improvement initiatives.

Additional Functions and Responsibilities

• Support organizational quality initiatives, audit programs, and operational excellence efforts.
• Contribute to process improvement, knowledge sharing, and team development activities as needed.
• Perform other duties as assigned.