Senior Claims Adjuster - Complex Claims

Our client, a reputable insurance provider, is seeking an experienced and detail-oriented Senior Claims Adjuster to manage complex claims within their Indore, Madhya Pradesh, IN office. This on-site role requires a seasoned professional adept at investigating, evaluating, and negotiating settlements for challenging insurance claims across various lines of business.

The Senior Claims Adjuster will be responsible for handling a caseload of high-value and intricate claims, requiring thorough investigation to determine liability, coverage, and damages. You will interview claimants, witnesses, and insured parties, review policy documents, and gather necessary evidence. A critical part of this role involves analyzing complex financial records, medical reports, repair estimates, and legal documents to accurately assess claim values. You will negotiate settlements with claimants and their representatives, striving for fair and equitable resolutions while mitigating financial exposure for the company. This position demands a strong understanding of insurance law, claims handling best practices, and relevant industry regulations. You will also be responsible for maintaining detailed and accurate claim files, documenting all activities, communications, and decisions. Providing guidance and mentorship to junior adjusters, and collaborating with legal counsel on litigated claims are also key aspects of this role. Proactive claim management, clear communication, and a commitment to customer service excellence are paramount.

Responsibilities

Investigate, evaluate, and resolve complex insurance claims in accordance with policy provisions and company guidelines. Determine coverage, liability, and damages for assigned claims. Conduct thorough fact-finding, including interviews, site inspections, and evidence gathering. Analyze financial statements, medical records, repair estimates, and other relevant documentation. Negotiate settlements with claimants, policyholders, and legal representatives. Prepare detailed claim reports, settlement authorizations, and payment requests. Maintain accurate and timely documentation within the claims management system. Provide exceptional customer service and maintain professional communication throughout the claims process. Mentor and provide technical guidance to junior claims adjusters. Stay current with industry trends, regulatory changes, and legal developments affecting claims handling. Collaborate effectively with internal departments, external vendors, and legal counsel.

Qualifications

Bachelor's degree in Business Administration, Finance, Law, or a related field. Minimum of 5-7 years of experience in claims adjusting, with a significant focus on handling complex or specialty claims (e.g., property, liability, workers' compensation). Possession of relevant industry licenses or certifications (e.g., AIC, CPCU). Strong understanding of insurance policies, coverage principles, and claims investigation techniques. Excellent analytical, negotiation, and problem-solving skills. Proficiency in claims management software and standard office applications. Exceptional written and verbal communication skills. Ability to manage a complex caseload efficiently and effectively. Strong organizational skills and attention to detail. Demonstrated ability to work independently and as part of a team in an office environment.