ADJUSTER JOB DESCRIPTION

An Adjuster who handles a file poorly leaves insureds without settlements, contractors unpaid, and reserves that misstate a carrier's true exposure for months. This role owns the full investigation, coverage determination, and resolution of property and casualty claims, spanning everything from residential dwellings to commercial liability. State adjuster licensing requirements and Department of Insurance regulatory standards define the compliance floor every day. The Adjuster works alongside insureds, attorneys, independent appraisers, and SIU referrals, making judgment calls that directly set reserve levels and settlement authority.

As the Adjuster, you investigate, evaluate, and resolve P&C insurance claims in accordance with policy terms, jurisdictional statutes, and company authority guidelines, applying coverage analysis and damage estimation to reach equitable outcomes. You operate within a claims unit that handles caseloads ranging from routine first-party property losses to complex multi-party liability files, collaborating with appraisers, legal counsel, and vendor networks throughout resolution.

Career Impact: Holding a state adjuster license across multiple jurisdictions and earning designations such as AIC or CPCU builds a credential profile that opens doors to senior examiner, litigation specialist, and claims management tracks.

Business Impact: Accurate reserve-setting and timely settlements keep policyholders whole, reduce litigation exposure, and protect the carrier's combined ratio on active books of business.

Growth Opportunity: Handling progressively complex files, from standard property losses to litigated bodily injury and subrogation recovery, expands both technical range and market value within P&C claims.

• Investigate claims by gathering witness statements, police reports, photographs, recorded interviews, and official documents to establish facts of loss.
• Evaluate policy coverage, liability, and damages in compliance with state statutes, Department of Insurance requirements, and delegated authority limits.
• Establish, monitor, and adjust reserves with documented rationale throughout the claim lifecycle to reflect current exposure accurately.
• Inspect and scope property damage in person or virtually, writing damage estimates that meet carrier guidelines and regulatory standards.
• Negotiate settlements with insureds, claimants, attorneys, and repair facilities within the approved authority to achieve timely, equitable resolution.
• Identify subrogation and salvage opportunities, flag suspicious losses to SIU, and initiate recovery efforts where applicable.
• Coordinate independent adjusters, appraisers, structural engineers, and vendors to fully assess complex or large-loss claims.
• Document all claim activity in the claims management system, maintaining complete file notes, diaries, and regulatory correspondence.

Candidates often list reserve-setting but skip subrogation recovery metrics, which the resume samples by file complexity make concrete.

• Bachelor's degree in business, finance, or a related field, or equivalent work experience.
• 2 or more years of property and casualty claims adjusting experience, with demonstrated competency in coverage analysis and damage evaluation.
• Hold a valid state adjuster license in the state of domicile, with a willingness to obtain non-resident licenses as required.
• Working knowledge of insurance policy interpretation, liability theory, reserve methodology, and subrogation principles.
• Strong investigative, analytical, and negotiation skills with the ability to reach well-documented decisions on complex files.
• Effective written and verbal communication skills for interacting with insureds, attorneys, contractors, and internal stakeholders.
• Ability to manage a high-volume caseload, prioritize competing deadlines, and adapt to surge or catastrophe conditions.

What counts as strong coverage analysis shifts with seniority, and the competency bar for adjuster candidates draws that line.

• Associate in Claims (AIC), Associate in Risk Management (ARM), or CPCU designation, or active progress toward one.
• Experience handling litigated claims, including mediation attendance, deposition preparation, and coordination with defense counsel.
• Proficiency with property estimating platforms and multi-jurisdiction claim handling across at least two states.
• Bilingual capability, particularly Spanish, to support a broader insured population in high-volume service territories.

• Reserve adequacy rate, measuring how often initial reserves require a significant upward revision at closure.
• Average days to resolution per file, reflecting timely investigation and settlement within authority.
• Subrogation recovery rate as a percentage of identified recovery opportunities pursued to completion.
• SIU referral accuracy, tracking the proportion of flagged claims that result in confirmed fraud findings.
• Reopened claim rate, indicating how often closed files require additional investigation or payment.
• Typical tools: property estimating software (commonly Xactimate or Symbility); claims management systems (commonly Guidewire or Majesco).

Mapping Xactimate proficiency and AIC credentials to the adjuster career path is the quickest way to see where this role leads.

• Base Salary Range: $52,000 to $82,000 annually, varying by seniority and license scope.
• Bonus: Performance-based, typically 5% to 10% of base salary.
• Equity: Not typical for this role at most carriers.
• Health Benefits: Medical, dental, and vision coverage; standard US employer plan.
• PTO: 15 to 20 days annually, plus paid holidays.
• Common Perks: Mileage reimbursement, continuing education support for licensing and designations, remote or hybrid scheduling where claim type allows.

Figures are estimates based on general US market benchmarks and may be outdated. Adjust based on location, company size, and seniority level.

Employment is contingent upon successful completion of a background check and verification of work authorization in the United States. Reasonable accommodations are available to qualified individuals with disabilities throughout the application and employment process - please notify the hiring team of any accommodation needs. All applicants are considered without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other characteristic protected under applicable federal, state, or local law.

Match your Xactimate skills to a resume that reaches a hiring manager.

The Adjuster owns end-to-end inspection and damage estimation for residential property claims, using tools such as Xactimate to document and quantify loss across dwellings and structures. Working within regulatory and company service standards, the Adjuster collaborates with customers and their clients to support accurate claim resolution and identify subrogation and salvage opportunities.

Key Responsibilities

• Inspect and appraise damages to dwellings, other structures, and personal property.
• Identify damages, document the risk, and estimate the damages identified.
• Prepare diagrams and estimates utilizing Xactimate or other estimating software.
• Comply with federal and state regulations, delegated authority, and customer service standards.
• Maintain current knowledge of regulations, industry activity, and trends.
• Identify subrogation and salvage opportunities and communicate suspicious findings.
• Perform technical review of contractor property damage estimates.
• Maintain the expected case load as set by the Company.
• Interact with and maintain effective communications with customers and their clients at all times.
• Support workload surges and assist in implementing catastrophe plans as needed.

Required Qualifications

• Associate degree (A.A. or A.S.) or equivalent, Bachelor's degree (B.A. or B.S.) preferred.
• Hold Adjusters License for states in which the Company conducts business.
• 4 years of outside property adjusting experience.
• Demonstrated organization and time management skills.
• Must possess written and verbal communication skills.
• Fluency in Spanish preferred.
• Ability to work independently.

Embedded within the Claims team, the Adjuster investigates and resolves auto liability and damage claims by conducting thorough investigations, obtaining recorded statements, and negotiating settlements within approved authority. Working closely with internal and external customers, the Adjuster manages assigned inventory and communicates reserve adjustments and excess exposures to ensure timely, equitable claim outcomes.

Core Functions

• Evaluate and investigate policy coverage, liability, and damages on time following claim and statutory guidelines.
• Assist internal and external customers with claims inquiries by phone or written correspondence.
• Establish and adjust initial reserves for all potential exposures throughout the claim.
• Establish and maintain appropriate management of assigned inventory following company guidelines.
• Recognize excess exposures and communicate implications verbally and in writing.
• Recognize and resolve minor injury exposures.
• Conduct thorough investigations, including obtaining necessary documents and recorded statements.
• Ensure timely completion of appraisals and determine accident-related damages.
• Communicate with involved parties and negotiate appropriate settlements within the approved authority.
• Recognize recovery opportunities in subrogation and salvage.

Qualifications & Experience

• High School Diploma or equivalent required, Undergraduate Degree or equivalent experience preferred.
• INS or other insurance-related courses preferred.
• 2+ years of auto claims adjusting experience.
• Non-standard Auto experience a plus.
• Proficient in PC and Windows.
• Good critical thinking and investigative skills.
• Effective verbal and written communication, negotiation, time management, and organizational skills.
• Ability to perform basic math calculations, including averages and percentages.
• Proven ability to provide excellent customer service.

Reporting to the principal, the Adjuster participates in ongoing training across multiple adjusting departments while investigating, evaluating, and settling first and third-party commercial lines claims. Partnering with clients, field adjusters, and brokers, this role builds toward full licensure and CIP designation while managing client relations and maintaining accurate bordereau, billing, and claims file records.

Primary Duties

• Investigate, collect, and analyze claims information, including telephone interviewing of claimants and witnesses.
• Direct field adjusters to obtain evidence and obtain all official documents to complete claims.
• Evaluate coverage, liability, and quantum; confirm and document coverage.
• Assess evidence, apply liability analysis, and review medical records to reserve for damages.
• Negotiate, settle, and finalize claims with first and third parties.
• Facilitate payment, maintain bordereau, and maintain accurate billing and time and expense records.
• Record, report, and present files accurately; document all activities on the system and report promptly to the principal.
• Maintain master claims file and complete accurate time capture, docketing, and client invoicing.
• Manage client relations, ensure compliance with client programs and standards, and resolve inquiries expeditiously.

Skills & Qualifications

• Pursuing post-secondary education in an insurance-related field, working towards a full license and CIP designation.
• Knowledge of commercial and personal lines in both Property and Auto PD.
• Ability to conduct telephone investigations, evaluate, negotiate, and settle first and third-party commercial lines claims.
• Proficient in maintaining accurate and detailed activity, transaction, and reserve records.
• Advanced computer skills, including Office 365 and Windows 10.
• Excellent communication skills in both French and English (bilingualism considered an asset).
• Strong team player with commitment to quality, customer service, and continuous learning.

Sitting at the intersection of customer service and claims operations, the Adjuster handles all correspondence, database entry, and settlement coordination between the insurer and customers while interpreting policy terms and administering supplier invoicing. Operating across repair firms, internal systems, and client accounts, the Adjuster ensures same-day documented responses and minimal disputed submissions in line with company policy standards.

Duties

• Handle all verbal and written correspondence between Crown and the Customer.
• Enter information in internal and Claims databases.
• Settle claims in the database and request organisation as required.
• Coordinate repair firms to substantiate claims and determine repair options.
• Collate information required to adjust any claim; adhere to all systems and procedures in the settlement process.
• Interpret and apply policy terms and conditions; ensure customer understanding during settlement.
• Administer supplier invoices and charges for payment.
• Provide same-day documented response to all customer contacts and settle claims within established timeframe.
• Maintain minimal disputed or rejected claim submissions and delight customers in line with policy.

Requirements

• Minimum of 1 year of insurance claims handling experience.
• Proficient in IT, including Word and Excel.
• Excellent verbal and written communication skills in English (additional language skills a plus).
• Strong attention to detail with a structured approach to work.
• Ability to work as part of a team and react to business priorities.
• Demonstrate calmness under pressure.
• Able to embrace change and demonstrate good commercial acumen.

A key member of the Claims team, the Adjuster leads investigation, coverage analysis, and resolution of medium to complex Auto Physical Damage claims involving multiple parties, liability decisions, and jurisdictional statutes. Collaborating across the Core claim handling team, Total Loss, and rental and repair facilities, the Adjuster manages specialty exposures such as Garagekeepers' and Inland Marine claims while supporting onboarding and mentoring of new hires.

Functions

• Gather information, including witness statements, police reports, photographs, and appraisals of damages.
• Determine appropriate appraisal channel based on facts of the case.
• Calculate rental days needed and work with repair and rental facilities to manage timelines.
• Understand and comply with state requirements on written/oral communication and liability.
• Determine total loss situations and ensure successful transition to Total Loss team.
• Coordinate with Core claim handling team on claims involving property damage and bodily injury.
• Handle specialty areas such as Garagekeepers' and Inland Marine claims as needed.
• Assist with onboarding, training, and mentoring new hires.

Experience & Qualifications

• Hold state licensure as required.
• 1-3 years of claims handling experience.
• Knowledge of insurance theory and practices, including Commercial Auto, Garage Keepers, and total loss.
• Demonstrated skills in investigation, evaluation, and negotiation.
• Proficient with MS Office Suite.
• Ability to travel as required.

Effective and equitable general liability claim resolution depends on the Adjuster, who analyzes policy coverage, manages reserves, directs independent adjusters and appraisers, and handles total losses, subrogation, and salvage. Based within a claims operation requiring a four-year degree and five years of claims handling experience, the Adjuster maintains daily contact with insureds, claimants, attorneys, vendors, and agents to drive thorough, well-documented outcomes.

Accountabilities

• Analyze, review, and interpret policies to assess coverage and liability.
• Establish and maintain proper loss and expense reserves.
• Determine necessary investigation on complex claims to reach equitable conclusions for all parties.
• Control work done by independent adjusters and appraisers.
• Document, verify, and review damages; evaluate and settle claims; investigate subrogation; handle total losses and process salvage returns.
• Maintain daily contact with adjusters, insureds, claimants, attorneys, vendors, and agents.

Technical Qualifications

• Hold a four-year degree from an accredited institution or equivalent experience.
• Hold a state adjuster's license where domiciled and non-resident licenses where required.
• 5 years' claims handling experience, including coverage, investigation, litigation, negotiation, damage/injury evaluation, salvage, and subrogation.
• Knowledge of state laws and regulations governing general liability claims handling.
• Basic understanding of claims, mathematics, construction, auto physical damage, medical terms, and legal issues.

As the Adjuster, this role shapes the full lifecycle of complex litigated Property and Casualty claims by conducting investigations, analyzing coverage, managing litigation, and negotiating conclusions within authority limits. The claims operation relies on this work to ensure timely reserve analysis, mediation attendance, subrogation recovery, and presentation of claims in round-table reviews.

Activities

• Conduct investigations, establish facts of loss, analyze coverage, determine liability and negligence, investigate risk transfer, manage litigation, and negotiate claims to conclusion within authority limits.
• Complete timely and appropriate reserve analysis and reports.
• Handle litigated cases and attend mediation on assigned files.
• Prepare and present claims in round-table settings or claim reviews.
• Determine subrogation opportunities and initiate recovery efforts.

Position Requirements

• College degree preferred.
• Designation (AIC, AIM, ARM, CPCU) and/or insurance-related courses a plus.
• 7+ years in the Property and Casualty industry with 5+ years handling complex litigated claims.
• General Liability experience preferred.
• Public Entity experience a plus.
• Proficient in claims management systems and Microsoft Office (Outlook, Word, Excel, PowerPoint).
• Willingness to travel as required.

Field Adjuster builds a career pathway by applying existing claims management skills to the settlement of household and property insurance claims, guiding customers through loss and reinstatement from first contact through resolution. Success in the position means managing claim documentation and settlement outcomes efficiently while communicating with client insurers and brokers to achieve fair results.

Operational Focus

• Liaise with customers who have suffered a loss and support them through the process.
• Facilitate and assist with the settlement of insurance claims.
• Organise the reinstatement of damaged items and property.
• Review claim documentation and deliver settlement outcomes.
• Communicate with client insurers and brokers.

Background & Experience

• Property claim management experience or similar transferable skills.
• Customer service experience required.
• Self-starter with strong organisational, interpersonal, and problem-solving skills.
• Excellent written and verbal communication skills.
• IT competent.
• A willingness to be flexible for the business.

The Adjuster produces efficient, safe operation of converting equipment by setting up, adjusting, troubleshooting, and maintaining a range of machines to meet job specifications in a high-volume production environment. Reporting to the Supervisor, the Adjuster works alongside machine operators and training staff to minimize waste, ensure product quality, and communicate recurring equipment issues with documented corrective actions.

Key Deliverables

• Set up and adjust various types of converting equipment for safe and efficient operation including start-up, operation, parameter adjustment, maintenance, troubleshooting, and cleaning.
• Review job tickets to determine tools, parts, and materials necessary for machine changes and adjustments.
• Perform standard and special machine adjustments to meet job specifications.
• Troubleshoot problems and repair or replace damaged or worn machine components.
• Examine, test, and measure product from assigned equipment and ensure quality process is followed.
• Analyze mechanical issues and take corrective action; perform preventative maintenance inspections.
• Minimize waste by ensuring proper segregation, weighing, recording, and disposal.
• Provide coverage for machine operators and assist in adjuster/operator training as needed.
• Notify Supervisor of recurring equipment problems and corrective actions taken; comply with all safety rules and company policies.

Minimum Qualifications

• Minimum High School Diploma or equivalent.
• Minimum 2 years previous print mechanical experience.
• 4 years envelope adjuster experience preferred.
• Experience with Envelope equipment (202, RA, SW, 627, 249, etc.).
• Excellent mechanical, troubleshooting, and problem-solving skills.
• Basic math skills and ability to read a ruler.
• Basic computer and communication skills.
• Ability to work at a rapid pace, meet deadlines, and adapt quickly to changing priorities.

Embedded within a defined service territory, the Field Adjuster advances customer-focused investigation and resolution of first-party personal and commercial property claims ranging from core to moderate complexity, independently scoping and writing estimates using Xactimate and interpreting policy contracts, forms, and endorsements. Working closely with vendors, structural engineers, independent adjusters, and internal teams, the Field Adjuster ensures reserves are current, settlements are negotiated within authority, and all state and federal regulatory requirements are met.

Role Responsibilities

• Determine the root cause of loss, subrogation and salvage potential, suspicious circumstances, and conduct recorded interviews, and coordinate outside experts.
• Determine coverage by interpreting policy contracts, forms, and endorsements, and adjust all claim elements, including ALE, business interruption, scheduled property, and coverage questions.
• Independently inspect, scope, and write property estimates using estimating guidelines and Xactimate; estimate routine to moderately complex losses in person or virtually.
• Make timely, well-informed decisions, think critically to anticipate and develop proactive solutions.
• Identify and recommend suspicious losses to SIU, and ensure accuracy of information and guard against fraudulent claims.
• Prepare accurate file notes, reports, and letters, and maintain complete, well-documented files and updated claim diaries.
• Establish and update reserves, negotiate settlements, and authorize payments within scope of authority.
• Ensure exceptional customer service throughout the claim process, including timely response to all communications and adherence to Department of Insurance requirements.
• Coordinate vendor services and obtain information from experts to fully assess extent of loss, and manage independent adjusters, consultants, and structural engineers.
• Comply with all state and federal regulations, core values, and established processes, and maintain professional knowledge through continuing education.

Knowledge, Skills & Abilities

• Bachelor's degree or equivalent combination of education and experience.
• Hold appropriate adjuster licensing as required by the state and a valid driver's license with an insurable driving record.
• Personal and commercial lines claims experience.
• Knowledge of multi-jurisdiction property claim handling, insurance laws, and building/construction.
• Intermediate computer and typing skills, including Microsoft Office Suite and Xactware products.
• Strong interpersonal, communication, analytical, and problem-solving skills with the ability to deliver technical information to non-technical audiences.
• Excellent organizational skills with the ability to prioritize, balance projects, and adapt in a fast-paced environment.
• Ability to work extended hours, weekends, and travel up to 25% of the time; must maintain a home-based internet connection.
• Able to sit/stand for extended periods, operate a motor vehicle 4-5 hours daily, load/unload equipment up to 45 lbs, and safely use a ladder while inspecting roofs and building exteriors.

Reporting to the Claims Manager, the Claims Adjuster develops coverage analysis, estimates building repairs using Xactimate, and manages a caseload spanning all complexity levels for first-party and litigated Florida property claims. Partnering with insureds, public adjusters, attorneys, and contractors, the Claims Adjuster I ensures reserve accuracy, mediation participation, and full compliance with Best Practices and statutory requirements.

Day-to-Day Responsibilities

• Verify facts of loss and confirm coverage, identify and refer claims with subrogation potential, NICB fraud indicators, and Reservation of Rights correspondence.
• Establish and monitor ultimate reserves, submit reserve and payment approval requests in a timely manner.
• Explain and respond to insureds, public adjusters, attorneys, and contractors, and provide timely investigation updates and explain settlements.
• Identify claims for DFS Mediation or appraisal, attend mediations and apply negotiation skills to facilitate resolution.
• Coordinate the appraisal process and maintain communication to ensure timely binding awards.
• Report serious injuries, liability claims, and large loss claims to the appropriate Claims Manager.
• Attend and give sworn testimony in depositions and court proceedings involving property claims.
• Write and reconcile building repair estimates for property claims involving all perils, virtually investigate and resolve claims using video technology as appropriate.
• Adhere to Best Practices, Operational Guidelines, and statutory requirements, and complete and close file documentation promptly.
• Meet minimum expectations in internal and external audits and assist management with projects or leadership requests, including travel as needed.

Education & Experience

• High School graduate required, college degree preferred.
• Hold a Florida 620 All Lines Adjuster License.
• 5 years of Florida property field experience, or 3 years of field experience plus 2 years of Florida property desk adjusting experience.
• Proficient in Xactimate and XactAnalysis.
• Advanced interpersonal, written, and verbal communication skills.
• Strong organizational and time management skills.

Sitting at the intersection of legal compliance and medical management, the Adjuster independently investigates, evaluates, and resolves complex Workers Compensation claims in accordance with jurisdictional statutes and company guidelines, with particular focus on Pennsylvania jurisdiction and highest risk management expectations. Operating across legal, medical, and vendor channels, the Adjuster collaborates with PMA nurse professionals, service vendors, and supervisors to execute action plans spanning medical management, litigation, negotiation, and return-to-work strategies.

What You'll Do

• Promptly investigate all assigned claims, including complex cases, with minimal supervision.
• Determine coverage, compensability, subrogation potential, and second injury fund applicability; alert Supervisor and SIU to suspect claims.
• Establish, maintain, and adjust reserves with documented rationale within granted authority.
• Ensure timely denial or payment of benefits in accordance with jurisdictional requirements.
• Establish and implement action plans for case resolution, including medical management, litigation, negotiation, and disposition.
• Collaborate with PMA nurse professionals to develop and execute return-to-work strategies.
• Select and manage service vendors to balance allocated expense and loss outcomes.
• Negotiate claim settlements and authorize treatment per established protocols and applicable statutes.
• Provide high-level customer service, including face-to-face interactions at claim reviews and stewardship meetings.

Professional Experience

• Bachelor's degree and/or equivalent work experience.
• Associate in Claims (AIC) Designation or similar professional designation desired.
• 1-4 years of lost time Workers' Compensation adjusting experience.
• Pennsylvania jurisdictional experience required, municipality experience a plus.
• Working knowledge of Workers' Compensation regulations and medical terminology.
• Proficient in MS Office Suite (Word, Excel, PowerPoint).
• Strong organizational, critical thinking, and decision-making skills with attention to detail.
• Strong verbal and written communication, and customer service skills.
• Ability to work independently and manage multiple tasks simultaneously.
• Ability to travel for business purposes less than 10%.

A key member of the Charles Taylor claims team, the Loss Adjuster advances on-site verification, client liaison, and detailed reporting across commercial property and liability claims, attending sites to confirm cause and extent of damage and helping businesses quantify income loss during closures. Collaborating across insureds, insurers, brokers, surveyors, and legal parties, the Loss Adjuster manages professional workload, builds client relationships, and supports internal audit requirements.

Scope of Work

• Attend the site to verify the cause and extent of damage and report to insurers.
• Liaise and correspond with insureds, insurers, brokers, surveyors, and other interested parties to progress individual claims.
• Ensure the site is secure to prevent further damage and organise salvage, building repairs, or clean-up operations.
• Verify that loss or damage is sufficiently covered under the policyholder's insurance policy.
• Investigate suspicious claims and negotiate and resolve disputed claims; provide evidence in court in fraud cases.
• Help businesses quantify loss of income during premises closure and advise on security precautions to reduce future losses.
• Prepare detailed reports covering legal and policy liability, potential quantum, and future actions; collate and interpret documentation.
• Research technical and legal questions by analysing and extracting relevant data from various sources.
• Maintain and build client relationships, manage individual professional workload, and assist with internal audit requirements.

Qualifications & Experience

• Proficient in IT with strong organisational skills and attention to detail.
• Excellent communication, interpersonal, and diary management skills.
• Ability to plan and manage workload to meet deadlines and work under pressure with conflicting demands.
• Attention to detail, ensuring accuracy 
• Ability to demonstrate the company's six core values, including excellence, partnership, and entrepreneurship.
• Maintain a valid driver's license with a good driving record.

Senior-level property claims expertise enables the Claims Adjuster to perform end-to-end claims adjusting within AEGIS London's syndicate, handling Property class of business claims from initial receipt through settlement while managing loss adjusters, external experts, and DOCOsoft workflow systems. Based within the London market and serving brokers, clients, and underwriters, the Claims Adjuster advises the head of department on claims movements and trends and ensures the syndicate meets ECF turnaround and customer service standards.

Strategic Responsibilities

• Perform claims adjusting in accordance with AEGIS London's claims commitment, philosophy, and procedures.
• Handle Property class of business claims within the agreed authority from the Head of Claims.
• Ensure the Syndicate meets internal and external standards for claims handling and customer service, including ECF and paper file turnaround times.
• Manage end-to-end claims processes using Syndicate systems such as DOCOsoft workflow.
• Maintain positive relationships with clients, brokers, and third-party experts; liaise with underwriters on claims issues and policy interpretation.
• Actively manage loss adjusters and experts to ensure claims and fees are handled appropriately and timely.
• Advise the head of department on relevant claims movements, issues, and trends; undertake ad hoc tasks and projects as required.

Minimum Qualifications

• Demonstrable claims background within the property lines of business.
• Part ACII qualified or working towards ACII.
• Working knowledge of London market claims systems (ECF).
• Technically sound claims knowledge with proficiency in Word, Excel, and similar applications.
• Excellent written and verbal communication and presentation skills.
• Well-developed analytical and problem-solving skills.
• Team player with a positive and flexible attitude.
• Ability to work accurately under tight deadlines.

As the Adjuster, this role oversees the timely and equitable processing and settlement of North American Property D&F claims within the London Market, managing ECF systems for both Lloyd's and LIRMA markets and liaising with service providers, including loss adjusters and associated experts. The claims function relies on this work to produce feedback to underwriters and management on claim issues, attend market meetings, and uphold Lloyd's minimum standards and Tokio Marine HCC core values.

Work Activities

• Ensure all allocated claims are controlled within the company's philosophies and SLAs.
• Demonstrate that Lloyd's minimum standards are met at all times and assist underwriters and claims adjusters to progress.
• Produce feedback to underwriters and management on claim issues and related risk information to improve underwriting standards.
• Attend market meetings and conference calls as necessary.
• Ensure customers are treated fairly at all times and promote Tokio Marine HCC's core values to internal and external contacts.
• Undertake ad hoc activities and project work as required.

Technical Qualifications

• 3+ years of experience managing North American Property D&F claims in the London Market, international claims experience considered.
• Hold an ACII qualification or be working towards it.
• Excellent knowledge of ECF for both Lloyd's and LIRMA markets.
• Sound technical First Party Property coverage knowledge.
• Working knowledge of North American service providers, including loss adjusters and associated experts.
• Excellent interpersonal, written, and verbal communication, and time management and organisational skills.
• Strong team player with a can-do attitude.
• IT literate, including Microsoft Word, Excel, and Outlook.

Unrepresented Complex Injury Adjuster refines the investigation, liability evaluation, and settlement of moderate to complex bodily injury auto and motorcycle claims using recorded statements, photos, police reports, and medical record analysis. The work directly supports a virtual claims team serving customers in PST and MST time zones, requiring independent judgment, data-driven negotiation, and flexibility for extended or weekend hours.

Performance Expectations

• Communicate empathetically with customers and assist them through their claim process.
• Investigate single and multi-vehicle auto accidents involving property damage and moderate to complex bodily injury using innovative tools, including recorded statements, photos, and police reports.
• Document claims through active listening and data analysis to assess coverage, liability, and damages while reviewing medical records and bills.
• Summarize liability decisions, evaluate injury claim value, and negotiate and settle with customers in accordance with business unit methodologies.
• Use data and analytics to problem-solve and contribute to team goals by sharing ideas and opinions.
• Work independently as part of a virtual team with flexibility for extended or weekend hours.

Required Qualifications

• Hold a bachelor's degree and/or have prior customer service experience.
• 2+ years of third-party casualty injury handling and evaluating experience.
• Ability to handle moderate, severe, and complex injuries in auto and motorcycle accidents.
• Proficient in Microsoft Office Suite with a willingness to learn new technology.
• Empathetic, organized, and able to multi-task in a fast-paced environment.
• Clear written and verbal communication skills.
• Bilingual and/or prior military experience a plus.

The Repped BI Adjuster coordinates the investigation, evaluation, negotiation, and settlement of moderate to severe and fatal bodily injury and personal injury protection claims within established time limits, with California adjusting experience required for a remote PST-based position. Reporting to upper claims management and working independently across multiple states, the Repped BI Adjuster submits large loss reports, analyzes complex medical records, and adjusts UM/UIM policies to achieve timely, well-documented outcomes.

Leadership Responsibilities

• Initiate thorough coverage and liability investigations and draft coverage letters as appropriate.
• Evaluate and resolve moderate to severe and fatal bodily injury claims, promptly review and respond to all demands, including time limit demands.
• Obtain and analyze complex medical records and data, research and apply applicable laws across multiple states.
• Submit timely large loss reports and referrals to the home office and prepare quality presentations of high-exposure cases to upper claims management.
• Timely reserve losses, monitor reserve adequacy, and skillfully negotiate settlements with claimants and attorneys.
• Adjust insurance policies for UM/UIM claims.

Background & Experience

• High School Diploma required.
• Must obtain adjuster licensing in all states where required.
• 2+ years of experience handling complex and severe first-party and bodily injury claims.
• High exposures in a multi-state area.
• California adjusting experience required.
• Proficient with computer software, including the Guidewire claims system.
• Detail-oriented with strong problem-solving, time management, organizational, and verbal and written communication skills.
• Ability to work independently and as part of a team with decisiveness within authority.

Embedded within a litigation-focused claims team, the Severe Represented & Litigation Adjuster guides the full cycle of complex and highly complex claim resolution by managing customer communications, setting reserves, negotiating settlements, and applying advanced knowledge of insurance policy, coverage, and legal compliance standards. Working closely with claimants, attorneys, and internal stakeholders, the Severe Represented & Litigation Adjuster applies advanced analytical, negotiation, and arbitration procedures to evaluate claim value and drive accurate, well-documented file outcomes.

Ownership Areas

• Manage, research, and resolve complex customer communications, concerns, conflicts, and issues.
• Summarize documents and enter notes into the claim system.
• Determine and explain minimum coverage limits in complex claims involving single or multiple claimants and determine claim value.
• Document claim files with notes, evaluations, and decision-making rationale; set and update reserves with documented rationale and claim summary notes.
• Negotiate and settle claims in accordance with business unit best practices.
• Review medical reports in preparation for claims settlement evaluation.
• Research and respond to or resolve complex compliance issues.

Professional Experience

• Advanced knowledge of insurance policy, coverage, regulation, and claim processes, including liability, damage estimating, settlement, and legal compliance standards.
• Working knowledge of training facilitation and coaching skills.
• Understanding of advanced analytical procedures to reconcile and recognize data patterns.
• Strong negotiation, arbitration, and problem-solving skills.
• Ability to investigate, evaluate, negotiate, and settle complex and highly complex claims.