Parties, Roles, and Litigation Teams
Claims and Risk Roles
Claims examiners investigate coverage and liability, set reserves, direct defense counsel, evaluate exposure, and negotiate resolution. Authority levels vary by severity and carrier structure.
The claim file documents their handling.
Alternative Names:
Claim Handler, Claims Representative
Why it Matters?
The examiner is defense counsel's actual client contact even though the insured is the client, which is the tripartite tension defining insurance defense practice. Examiner authority limits also determine what can be resolved at mediation, and appearing with an examiner lacking sufficient authority wastes the session. Confirming the authority level before scheduling is a routine step that is frequently skipped.
Frequently Confused with
Related terms
Frequently asked questions
Who is defense counsel's client?
What should be confirmed before mediation?
