Bodily Injury Claims Adjuster

This is a fully remote position, open to applicants in Florida.

📋 Description

• Investigate, assess, negotiate, and resolve third-party bodily injury and liability claims in line with client directives and Davies best practices.

• Review all newly assigned claims within 24 hours and formulate an appropriate action plan.

• Reach out to insured individuals, claimants, attorneys, and other relevant parties within 24 hours of claim assignment.

• Carry out comprehensive investigations to establish liability, causation, damages, and exposure.

• Secure recorded statements from claimants, insured individuals, witnesses, and other relevant parties as required.

• Collect and analyze evidence, including medical records, photographs, police reports, expert reports, and witness statements.

• Organize appraisals, damage assessments, and field investigations as needed.

• Assess the injury status of all parties involved in claims and accident investigations.

• Analyze coverage, liability, damages, and potential settlement exposure.

• Review claims involving attorneys and ascertain the necessary level of legal involvement.

• Negotiate settlements within given authority and seek approval for payments in accordance with client and company guidelines.

• Maintain precise reserves and suggest adjustments based on claim developments.

• Manage litigated claims and collaborate with defense counsel when assigned.

• Promptly inform management and clients of any Summons and Complaints received.

• Monitor the performance of defense counsel and obtain status updates at a minimum of 90-day intervals.

• Evaluate field adjuster reports for thoroughness, accuracy, and completeness.

• Conduct ISO ClaimSearch reports on injured claimants and assess findings as necessary.

• Report qualifying claims to excess carriers and provide timely updates on their status.

• Address Reservation of Rights inquiries and communications from carriers as required.

• Develop and sustain a thorough understanding of No-Fault/PIP statutes and regulations.

• Ensure compliance with Medicare reporting and follow company protocols when resolving claims involving Medicare recipients.

• Review claims for adherence to applicable sovereign immunity statutes and governmental liability requirements, including Florida Statute 768.28 when applicable.

• Maintain complete and timely claim documentation, including file notes, correspondence, and workflow activities.

• Keep diary systems and follow-up schedules to ensure prompt claim progression and resolution.

• Achieve established service standards, closure objectives, productivity targets, and quality metrics.

• Retain necessary adjuster licenses and fulfill continuing education requirements.

• Support colleagues, supervisors, and management with special projects and claim-related assistance as needed.

⛳️ Requirements

• A college degree or equivalent experience in claims handling is preferred.

• An active Adjuster License is required, or the ability to obtain and maintain the necessary licensing.

• A minimum of 3+ years of experience in handling bodily injury claims.

• Experience with:

• Auto Liability Claims

• General Liability Claims

• Errors & Omissions Claims

• Law Enforcement Liability Claims

• A strong understanding of:

• Tort law

• Liability analysis

• Bodily injury evaluation

• Medical terminology

• Coverage interpretation

• Litigation management

• Proven experience in independently managing claims from assignment to closure.

• Experience working with defense counsel and litigated files is preferred.

• Familiarity with Medicare reporting obligations and excess carrier reporting protocols is advantageous.

• Knowledge of ISO ClaimSearch and industry-standard claims platforms.

• Excellent negotiation and settlement abilities.

• Outstanding written and verbal communication skills.

• Strong organizational, documentation, and time management capabilities.

• Ability to prioritize multiple tasks in a fast-paced environment.

• Strong analytical, investigative, and problem-solving skills.

• Proficient in Microsoft Office Suite and claims management systems.

• Capability to work independently with minimal supervision while ensuring high-quality claim outcomes.

🏝️ Benefits

• Medical, dental, and vision insurance plans to support your health and that of your family.

• A 401(k) plan with employer matching contributions.

• Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees.

• Paid holidays.

• Life insurance along with short-term and long-term disability coverage.