Additional Information
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.
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Construction Defect Adjuster
Job Description
Primary 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.
Sedgwick · Telecommuter, FL