Senior Claims Adjuster (Complex Claims)

Our client, a leading national insurance provider, is seeking an experienced and detail-oriented Senior Claims Adjuster to manage complex claims cases in **Ahmedabad, Gujarat, IN**. This role is essential for ensuring fair and efficient resolution of high-value and intricate insurance claims, upholding the company's commitment to customer satisfaction and financial integrity.

As a Senior Claims Adjuster, you will be responsible for investigating, evaluating, and negotiating settlement of a wide range of complex insurance claims, including property, casualty, and liability. This involves detailed examination of policy coverage, assessment of damages, determination of liability, and management of claim reserves. You will interact directly with policyholders, legal counsel, and other stakeholders, requiring exceptional communication and negotiation skills. The ideal candidate will possess a deep understanding of insurance law and regulations, a strong analytical ability, and a proven track record of successfully managing challenging claims. This position requires a high degree of autonomy and decision-making authority.

Key Responsibilities:

Investigate, evaluate, and negotiate complex insurance claims, including property damage, bodily injury, and liability claims. Conduct thorough reviews of insurance policies to determine coverage and obligations. Assess damages and determine liability by gathering evidence, interviewing witnesses, and consulting experts. Manage claim reserves accurately and efficiently, ensuring financial soundness. Communicate effectively and empathetically with policyholders throughout the claims process. Negotiate settlements within company guidelines and legal frameworks. Liaise with legal counsel, medical providers, and other third parties as necessary. Prepare detailed reports and documentation for claim files and regulatory purposes. Maintain compliance with all relevant insurance laws, regulations, and company policies. Identify potential fraud indicators and escalate suspicious claims for further investigation. Provide guidance and mentorship to junior claims adjusters. Stay current with industry best practices, legal developments, and claims management techniques. Represent the company in mediations or other dispute resolution processes. Qualifications:

Bachelor's degree in Business Administration, Law, Finance, or a related field. Minimum of 5-7 years of experience as a Claims Adjuster, with a significant focus on complex claims. Possession of relevant insurance certifications (e.g., CPCU, AIC) is highly desirable. In-depth knowledge of insurance policies, claims handling procedures, and relevant legal principles. Strong analytical, critical thinking, and problem-solving skills. Excellent negotiation, communication, and interpersonal skills. Ability to manage a caseload of complex claims efficiently and effectively. Proficiency in claims management software and standard office applications. High level of integrity, professionalism, and ethical conduct. Ability to work independently and make sound judgments under pressure. A valid driver's license and willingness to travel occasionally for site inspections if required. This is an excellent opportunity for an accomplished claims professional to advance their career in **Ahmedabad, Gujarat, IN**, with a respected insurance leader.