Bodily Injury Claims Adjuster

Key Responsibilities

• Investigate, evaluate, negotiate, and resolve third-party bodily injury and liability claims in accordance with client guidelines and Davies best practices.
• Review all new claim assignments within 24 hours and develop an appropriate plan of action.
• Contact insureds, claimants, attorneys, and other involved parties within 24 hours of claim assignment.
• Conduct thorough investigations to determine liability, causation, damages, and exposure.
• Obtain recorded statements from claimants, insureds, witnesses, and other involved parties as necessary.
• Gather and evaluate evidence, including medical records, photographs, police reports, expert reports, and witness statements.
• Coordinate appraisals, damage estimates, and field investigations when required.
• Determine injury status of all parties involved in claims and accident investigations.
• Analyze coverage, liability, damages, and settlement exposure.
• Evaluate claims involving attorneys and determine the appropriate level of legal involvement.
• Negotiate settlements within authority and seek payment authorization in accordance with client and company requirements.
• Maintain accurate reserves and recommend adjustments based on claim development.
• Manage litigated claims and coordinate with defense counsel when assigned.
• Immediately notify management and clients of any Summons and Complaint received.
• Monitor defense counsel performance and obtain status updates at minimum 90-day intervals.
• Review field adjuster reports for thoroughness, accuracy, and completeness.
• Run ISO ClaimSearch reports on injured claimants and evaluate findings as appropriate.
• Report qualifying claims to excess carriers and provide timely status updates.
• Respond to Reservation of Rights inquiries and carrier communications as needed.
• Develop and maintain working knowledge of No-Fault/PIP statutes and regulations.
• Ensure Medicare reporting compliance and follow company guidelines when resolving claims involving Medicare recipients.
• Review claims for compliance with applicable sovereign immunity statutes and governmental liability requirements, including Florida Statute 768.28 when applicable.
• Maintain complete and timely claim documentation, file notes, correspondence, and workflow activities.
• Maintain diary systems and follow-up schedules to ensure timely claim progression and closure.
• Meet established service standards, closure goals, productivity expectations, and quality metrics.
• Maintain required adjuster licenses and continuing education credits.
• Assist colleagues, supervisors, and management with special projects and claim-related support as needed.

Skills, knowledge & expertise

• College degree or equivalent claims experience preferred.
• Active Adjuster License required or ability to obtain and maintain appropriate licensing.
• Minimum of 3+ years of bodily injury claims handling experience.
• Experience handling: 
  • Auto Liability Claims
  • General Liability Claims
  • Errors & Omissions Claims
  • Law Enforcement Liability Claims
• Strong understanding of: 
  • Tort law
  • Liability analysis
  • Bodily injury evaluation
  • Medical terminology
  • Coverage interpretation
  • Litigation management
• Experience independently handling claims from assignment through closure.
• Experience working with defense counsel and litigated files preferred.
• Knowledge of Medicare reporting requirements and excess carrier reporting procedures preferred.
• Familiarity with ISO ClaimSearch and industry-standard claims platforms.
• Excellent negotiation and settlement skills.
• Exceptional written and verbal communication abilities.
• Strong organization, documentation, and time management skills.
• Ability to prioritize multiple assignments in a fast-paced environment.
• Strong analytical, investigative, and problem-solving skills.
• Proficiency with Microsoft Office Suite and claims management systems.
• Ability to work independently with minimal supervision while maintaining high-quality claim outcomes.