Senior Casualty Examiner

Job description

This role offers flexibility and may be based remotely or in one of MMGs regional offices, depending on the candidate and business needs. Must be located in ME, NH, VT, VA or PA to be considered. 

The Senior Casualty Examiner is responsible for the investigation, evaluation, reserving, negotiation, and resolution of high‑exposure, high‑severity, and complex casualty claims, including large loss matters. This role requires advanced technical expertise, sound judgment, and strong communication skills.

The Senior Casualty Examiner independently manages litigated and non‑litigated claims, identifies and addresses coverage issues, partners with defense counsel and external vendors, and supports the development of other claims professionals through collaboration and informal mentoring.

Prior litigation experience and commercial claims handling, including construction defect claims, is preferred. Familiarity with claims handling in VA, PA, VT, ME, and NH is also preferred.

What You’ll Do:

• Investigate, evaluate, reserve, negotiate, and resolve high‑exposure and complex casualty claims in accordance with company guidelines and best practices. 
• Identify coverage issues and draft reservation of rights or denial letters, as appropriate.
• Conduct thorough investigations, including obtaining recorded statements, reviewing police and medical records, and evaluating liability and damages. 
• Establish and maintain appropriate reserves supported by timely documentation and ongoing claim evaluation. 
• Manage litigated files in partnership with defense counsel, including strategy development, discovery oversight, and evaluation of settlement opportunities. 
• Prepare cases for and represent MMG at mediations, arbitrations, and other alternative dispute resolution proceedings. 
• Direct and manage independent adjusters, investigators, appraisers, experts, and other external vendors as needed. 
• Communicate clearly and professionally with insureds, claimants, attorneys, agents, medical providers, and internal business partners. 
• Identify subrogation opportunities and prepare files for recovery. 
• Develop and maintain positive working relationships with agents, independent adjusting firms, attorneys, and vendors. 
• Travel as required to perform essential job functions, attend meetings, training, or educational opportunities. 
• Perform other duties as assigned.

 
 What You Bring:

• Bachelor’s degree and 8–10 years of casualty claims experience, or an equivalent combination of education and experience.
• Demonstrated experience handling high‑exposure, high‑severity, and large loss casualty claims, including complex injury and litigated matters. 
• Advanced knowledge of casualty coverages, policy interpretation, and reserving practices, with the ability to evaluate claims involving significant financial impact. 
• Proven ability to independently manage litigated files, including working with defense counsel, evaluating risk, and developing resolution strategies. 
• Strong negotiation skills and the ability to clearly articulate and defend claim decisions in adversarial situations. 
• Excellent written and verbal communication skills, including the ability to draft clear, professional coverage correspondence.
• Proven ability to manage complex workloads independently while meeting deadlines and service expectations.
• Demonstrated professionalism, sound judgment, and the ability to remain calm and effective under pressure.
• Strong organizational skills and attention to detail.
• Ability to work collaboratively with internal partners and external vendors.
• Valid driver’s license and ability to travel up to approximately 25%, as business needs require.

Essential Functions
The essential functions of this position include investigating, evaluating, reserving, negotiating, and resolving of high‑exposure, high‑severity, and complex casualty claims, including large loss matters. These duties require the ability to work for extended periods at a computer, review and synthesize numerical and written information and interact effectively with internal and external stakeholders. This position is primarily performed in an office or remote work environment and requires prolonged periods of sitting and computer use. The role involves frequent verbal and written communication, participation in virtual and in‑person meetings, and occasional travel to client or company locations. Consistent with applicable law, reasonable accommodations will be made to support individuals with disabilities in performing the essential functions of their job provided that such accommodations do not impose an undue hardship on the business. The organization will engage in an interactive accommodation process as needed.