Sr Claims Adjuster - Coverage and Litigation Specialist

Job Title: Sr Claims Adjuster - Casualty

FLSA Status: Exempt

Job Family: Claims

Department: Casualty Claims

Location: Corporate Office (Fort Wayne, IN)

JOB SUMMARY

Responsible for effectively analyzing and resolving assigned serious/complex claims consistent with
claims department standards and company objectives.

POSITION ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential
functions.

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Handle assigned complex casualty claims, including claims involving catastrophic injuries and exposures arising under General Liability, Employment Practices Liability, Sexual Acts, Directors & Officers and other specialized coverages.

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Investigate and evaluate coverage, compensability, liability, damages, and potential exposure in complex or catastrophic claims. Consider applicable negligence standards, injury severity, medical treatment, venue, jurisdiction, and controlling legal doctrines while developing and managing litigation strategies.

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Retain, direct, and evaluate legal counsel, experts, and litigation vendors; monitor and manage loss adjustment expenses and litigation budgets and ensure compliance with applicable litigation and billing guidelines.

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Identify, investigate, and pursue available risk-transfer opportunities through analysis of applicable policies, indemnity agreements, contracts, tenders, and additional insured provisions.

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Analyze complex coverage issues through interpretation of policy language, endorsements, applicable law, and claim-specific facts. Identify, document, and effectively preserve applicable coverage positions and defenses.

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Prepare clearly supported coverage analyses and legally sound coverage position letters, coordinating with management and coverage counsel when the complexity, exposure, or legal issues warrant additional review.

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Promptly identify and escalate matters involving significant coverage questions, excess exposure, novel legal issues, reputational risk, or the need for specialized legal guidance.

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Negotiate and resolve complex or high exposure claims within delegated authority. Participate on behalf of the carrier, and in support of the insured, in strategy conferences, mediations, arbitrations, trials, and other claim-related proceedings.

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Provide technical consultation, coaching, and mentoring to claims personnel on coverage analysis, litigation management, claim evaluation, reserving, negotiation, and strategic claim handling.

KNOWLEDGE, SKILLS, AND ABILITIES

The requirements listed below are representative of the knowledge, skills, and/or abilities required to perform
each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with
disabilities to perform the essential functions.

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Demonstrated knowledge of tort law, nonprofit and ministry governance, and statutory frameworks applicable to religious organizations.

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Working knowledge of legal doctrines affecting religious organizations, including the Ministerial Exception and Church Autonomy Doctrine, and the ability to recognize matters requiring specialized legal analysis.

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Exercise sound judgment, discretion, tact, and confidentiality when handling sensitive or reputation-related claims.

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Strong negotiation, strategic-thinking, and analytical skills, including the ability to evaluate exposure, litigation risk, defense costs, and potential resolution outcomes.

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Communicate complex coverage issues, litigation developments, and risk evaluations clearly and concisely in verbal presentations, correspondence, claim-file documentation, and recommendations to management.

EDUCATION AND/OR EXPERIENCE

List Degree Requirement, Years' Experience, and Certifications

• Bachelor’s degree required.

• Must be able to take and pass mandatory adjuster licensing requirements.

• Must have five or more years of claim technical experience.

• CPCU designation strongly desired.

• Seven years or more of Brotherhood Mutual claims technical experience is desired.

Terms and Conditions

This description is intended to describe the general content of and requirements for the performance of this position. It is not to be construed as an exhaustive statement of duties, responsibilities, or requirements.

Because the company’s niche is the church and related ministries market, and because effective service requires a thorough understanding of this market, persons in this position must be familiar with church operations and must conduct themselves in a manner that will neither alienate nor offend persons within this target niche.

Brotherhood Mutual Insurance Company reserves the right to modify, interpret, or apply this position description in any way the company desires. This job description in no way implies that these are the only duties, including essential duties, to be performed by the employee occupying this position. This position description is not an employment contract, implied or otherwise. The
employment relationship remains “at-will”.