Claims Adjuster - General Liability

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.

Skills:

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

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.