Position Overview

The Claims Examiner is responsible for liability claims in the areas of: investigation, evaluation, reserving, negotiation and resolution of the companies’ claims in multiple jurisdictions.The position is required to follow established claims management standards and exercise solid judgment when solving business problems; using critical thinking and decision-making skills and judgment within their assigned authority levels. The Claims Examiner continually explores ways to apply claim’s best practices to business challenges.

Essential Functions

• Timely and effectively investigate and evaluate claims while managing outside adjusters and legal counsel
• Clearly and succinctly document files and prepare reports in timely manner
• Directs settlement activity using investigative and problem-solving skills in direct negotiations
• Handle all assigned cases efficiently and cost-effectively through conclusion
• Analyze and recommend appropriate reserves; periodically reviewing and adjusting these reserves based on the assessment of probable liability, financial responsibility and exposure
• Thoroughly review, analyze and interpret coverage in accordance with applicable policies
• Level of authority and complexity of decision making established by departmental management team
• Create and manage positive working relationships with internal and external business partners

Knowledge, Skills, Abilities

• Presents a positive and professional image of the companies
• Knowledge and commitment to company mission, vision and organizational values
• Ability to quickly assimilate and practically utilize new information
• Possess written and verbal communications skills required to review, understand, interpret and convey data including medical records and legal documents, and coverage interpretation
• Strong customer service skills including interacting with internal and external customers
• Team player; works effectively as part of a team

Job Requirements

Required:

• High School Diploma
• Bachelor’s degree in Business Management, Insurance, or related field, preferred; or equivalent work experience
• 3+ years of progressive liability claims handling experience
• Experience with the following claims: public officials’ errors and omissions, employment practices, law enforcement, mold, terrorism, lead based paint, employee benefit, and auto, preferred
• Experience with litigated claims, preferred
• All lines property/casualty adjuster’s license
• Ability to analyze and interpret coverage at a level commensurate with complexity of assigned claims
• Skilled in evaluating coverage issues and preparing clear, concise, and legally defensible coverage correspondence that accurately communicates claim decisions and policy provisions.
• Prepare and communicate written status reports, for policyholders, management and business partners, including treaty and facultative reinsurers, agents and brokers
• Understands current relevant case law and statutory law in multiple jurisdictions
• Ability to implement compliance processes and procedures to ensure consistent, efficient and effective compliance with all federal, state, local and filed requirements
• Review invoices, estimates, and other documents to ensure accuracy and legitimacy prior to payment
• Knowledge of insurance operations
• Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future
• Must be able to be on-site for two weeks for training upon hire in our Cheshire, CT office

Preferred:

• AIC designation
• Auto claims handling experience
• Knows the Public and Affordable Housing business

Work Environment and Physical Demands

• Inside climate-controlled office building
• Prolonged sitting and using a PC

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Department Overview

The HAI Group Claims Department provides expertise and guidance to HAI Group members and insureds. We partner with our constituents to solve complex problems and facilitate favorable solutions. The team has deep subject matter expertise on the claims process and its financial impact to the insurance business and our insured’s operations. Our goal is to achieve excellence using conceptual and critical thinking to serve the customer and add value to the partnership. We collaborate with our members and insured’s to make the most appropriate business decisions that assure timely, fair and favorable resolution of claims. The team works closely with all other departments within HAI Group’s insurance operation to coordinate a high level of service to our members and insureds.

Company Overview

HAI Group®[1] is the nation’s leading property-casualty insurance company founded by and dedicated to affordable housing organizations. While we are recognized as a pioneer of affordable housing insurance programs, insurance is not our only strength. We protect, preserve, and promote the sustainability of affordable housing with an array of products and services that support the challenges housing organizations face. HAI Group offers risk control and consulting services, professional development through the Housing Training Institute, and industry research and data through the Public and Affordable Housing Research Corporation. Headquartered in Cheshire, Connecticut, HAI Group has earned national and regional recognition for its workplace culture and employee experience. Visit our Careers page for a full list of HAI Group workplace awards and recognition.

Cultural Objective

HAI Group contributes to a culture that creates a safe and healthy working environment and a space of inclusiveness and belonging for all by: exceeding our customers’ expectations, working collaboratively across the organization, embracing diversity, and demonstrating mutual respect and empathy.

HAI Group Benefits and Perks

• Bonus program eligibility
• Annual merit increase program
• Outstanding 401(k) plan with match and additional non-elective company contributions
• Flexible work schedules
• Generous paid time off including paid volunteer days and holidays
• Medical, vision and dental Insurance
• Company paid life, AD&D, short-term disability, and long-term disability coverage
• HSA, and Health and Dependent Care FSA options
• On-Site wellness: Full gym and locker rooms, private wellness room (featuring a massage chair, lounge area, vibration plate, and a refrigerator, with accommodations for use as a private lactation space), wellness initiatives, outdoor basketball and tennis/pickleball courts, walking trail, picnic pavilion area
• Tuition reimbursement and student loan repayment program
• Professional development

HAI Group is an Equal Opportunity Employer.

HARRG Inc., reserves the right to fill this position at a level above or below the level included in this posting.

No agency submissions please. Resumes submitted to any HAI Group employee without a current, signed, and valid contract in place with the HAI Group Recruiting team for this position will become the property of HAI Group and no agency fees will be paid.

HAI Group's Notice of Collection of Personal Information: https://resources.haigroup.com/hubfs/2023-HAI-Notice-of-Collection-Employees_1099_Applicants.pdf

[1] HAI Group® is a marketing name used to refer to insurers, a producer, and related service providers affiliated through a common mission, management, and governance. Property-casualty insurance and related services are written or provided by Housing Authority Risk Retention Group, Inc.; Housing Authority Property Insurance, A Mutual Company; Housing Enterprise Insurance Company, Inc.; Housing Specialty Insurance Company, Inc.; Innovative Housing Insurance Company Inc.; Housing Investment Group, Inc.; and Housing Insurance Services, Inc. (DBA Housing Insurance Agency Services, Inc. in NY and MI).