The Claims Examiner is responsible for property 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
Review invoices, estimates, and other documents to ensure accuracy and legitimacy prior to payment
Prepare and communicate written status reports, for policyholders, management and business partners, including treaty and facultative reinsurers, agents and brokers
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; or equivalent work experience
3+ years of progressive property claims handling experience
All lines property/casualty adjuster's license
Experience analyzing and interpreting coverage at a level commensurate with complexity of assigned claims
Experience preparing and communicating written status reports to various parties
Understands current relevant case law and statutory law in multiple jurisdictions
Experience implementing compliance processes and procedures to ensure consistent, efficient and effective compliance with all federal, state, local and filed requirements
Knowledge of insurance operations
Preferred:
Five years of progressive property claims handling experience
AIC designation
Auto claims handling experience
Knows the Public and Affordable Housing business
Work environment & Physical Demands
Inside climate-controlled office building
Ability to lift 25lbs
<10% Travel
Prolonged sitting and using a PC
Must be legally authorized to work in the United States without need for sponsorship now or at any time in the future
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®[1], 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 insureds' business. 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 insureds 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 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. Besides insurance, we offer risk management services, online training, and consulting services used by more than 1,500 housing organizations nationwide. Headquartered in Cheshire, Connecticut, HAI Group® was recognized as a Top Workplace in 2020, 2021, 2022, 2023 and 2024.
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 program
Outstanding 401(k) program and non-elective contribution
Flexible work schedules
Generous paid time off, paid volunteer days and paid holidays
Medical, vision and dental Insurance
Company paid life, AD&D, short-term disability, and long-term disability coverage
HSA, FSA and dependent care options
On-Site wellness: Full gym and locker rooms, wellness initiatives, outdoor basketball and tennis court, picnic pavilion area
Tuition reimbursement and loan repayment
Professional development
Community outreach
(Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions)
HAI Group is an Equal Opportunity Employer.
[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).