建筑缺陷理赔员
Construction Defect Adjuster
加入Sedgwick,你将参与真正有意义的事业。我们的33,000名同事每天为全球面临意外的人们提供帮助。我们邀请你与我们共同成长,体验我们的关怀文化,并享受工作与生活的平衡。在这里,你所能实现的没有界限。
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建筑工程缺陷理赔员 主要职责
商业综合责任(CGL)索赔理赔员负责处理商业综合责任保单下产生的复杂第三方人身伤害和财产损失索赔的全流程。该职位需要在承保分析、责任认定、诉讼管理和风险转移方面具备高级专业知识,特别是在跨司法管辖区和建筑工程相关的风险暴露方面。理赔员需主动管理索赔结果,控制损失成本,并确保符合客户服务质量标准、监管要求和内部质量期望。
核心职责与任务
· 索赔调查与文件管理
- 独立调查并管理完整的CGL索赔案件,包括但不限于场所责任、滑倒受伤、产品责任、建筑工程缺陷及与建筑相关的损失,以及合同责任风险暴露。
- 通过积极的文件管理、战略规划以及遵循日志管理和文档记录的最佳实践,推动索赔及时解决。
- 承保分析与保单解释
- 分析复杂的保单条款,包括承保协议、附加条款、免责条款(如持续/完成作业、额外被保险人条款)和限额,以确定承保适用性。
- 起草清晰、可辩护的承保立场信函,包括保留权利通知和拒赔信,符合司法管辖区的要求和客户期望。
- 责任与损害评估
- 进行全面的责任调查,包括:
- 审查和分析事件报告、合同、租赁协议和赔偿条款
- 识别和应用合同中的风险转移条款
- 获取和评估录音陈述、专家意见、照片和监控录像
- 评估伤害严重程度、医疗治疗情况、
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By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies
Certified as a Great Place to Work®
Fortune Best Workplaces in Financial Services & Insurance
Construction Defect AdjusterPrimary Purpose
The Commercial General Liability (CGL) Claims Adjuster is responsible for the end-to-end handling of complex third-party bodily injury and property damage claims arising under commercial general liability policies. This role requires advanced expertise in coverage analysis, liability determination, litigation management, and risk transfer, particularly across multi-jurisdictional and construction-related exposures. The adjuster is expected to proactively manage claim outcomes, control loss costs, and ensure compliance with client service standards, regulatory requirements, and internal quality expectations.
Essential Functions and Responsibilities
· Claim Investigation & File Ownership
- Independently investigate and manage a full caseload of CGL claims, including but not limited to premises liability, slip and fall, product liability, construction defect and construction-related losses, and contractual liability exposures.
- Drive timely claim resolution through proactive file management, strategic planning, and adherence to best practices in diary management and documentation.
- Coverage Analysis & Policy Interpretation
- Analyze complex policy language, including insuring agreements, endorsements, exclusions (e.g., ongoing/completed operations, additional insured provisions), and limits to determine coverage applicability.
- Draft clear, defensible coverage position letters, including reservation of rights and denial letters, consistent with jurisdictional requirements and client expectations.
- Liability & Damages Evaluation
- Conduct comprehensive liability investigations, including:
- Review and analysis of incident reports, contracts, lease agreements, and indemnification provisions
- Identification and application of contractual risk transfer provisions
- Obtaining and evaluating recorded statements, expert opinions, photographs, and surveillance
- Evaluate injury severity, medical treatment, and long-term exposure, including review of medical records, bills, and independent medical evaluations (IMEs) where applicable.
- Establish, maintain, and adjust reserves in accordance with claim developments and severity exposure.
- Litigation Management
- Manage litigated files, including the retention and direction of defense counsel.
- Provide strategic oversight on litigation plans, budgets, pleadings, discovery, and dispositive motions.
- Participate in mediations, settlement conferences, and trial preparation, ensuring alignment with client and organizational strategies.
- Settlement & Negotiation
- Negotiate settlements within delegated authority while balancing cost containment and risk exposure.
- Evaluate settlement value based on liability, damages, venue, and litigation risks, and escalate appropriately when exceeding authority.
- Risk Transfer & Subrogation
- Identify, evaluate, and pursue risk transfer opportunities, including:
- Additional insured tenders
- Contractual indemnity provisions
- Subrogation potential
- Coordinate with coverage counsel, carriers, and third parties to maximize recovery and proper allocation of liability.
- Client & Stakeholder Communication
- Maintain proactive, professional communication with insureds, claimants, brokers, clients, and internal stakeholders.
- Provide detailed status updates, large loss reports, and claim summaries tailored to client-specific reporting requirements.
- Documentation, Compliance & Quality
- Maintain thorough, accurate, and timely file documentation to support claim decisions and audit readiness.
- Ensure compliance with applicable state regulations, client service instructions, and internal audit and quality standards.
- Participate in internal and external audits, file reviews, and continuous improvement initiatives.
Additional Functions and Responsibilities
· Support organizational quality initiatives, audit programs, and operational excellence efforts.
- Contribute to process improvement, knowledge sharing, and team development activities as needed.
- Perform other duties as assigned.
Qualifications
Education & Licensing
· Bachelor’s degree or equivalent work experience.
- Adjuster licensing as required by jurisdiction(s) handled.
Experience
· Minimum of 5+ years of commercial general liability claims handling experience required; experience with litigated and construction-related claims strongly preferred.
Skills & Knowledge
· Strong understanding of CGL coverage, policy interpretation, and jurisdictional differences
- Experience managing litigated claims and working with defense counsel
- Knowledge of construction defect, additional insured coverage, and risk transfer strategies
- Ability to assess liability, damages, and exposure in complex loss scenarios
- Strong negotiation and settlement skills
- Excellent written and verbal communication, including drafting coverage correspondence and client reports
- Proficiency in claims systems and Microsoft Office applications
- Demonstrated organization, attention to detail, and time management
- Ability to work both independently and collaboratively in a fast-paced, team-driven environment
- Proven ability to meet or exceed performance, quality, and compliance metrics
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($88,000 - $120,000 USD annually). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.
Originally posted on Himalayas