Claims Examiner – Spinnaker

Claims Examiner – Spinnaker

Job Title: Claims Examiner – Partner Programs

Location: Austin, TX / Dallas, TX / Bedminster, NJ / San Jose, CA 

Reports To: Claims Program Manager or Claims Manager

About Hippo

Hippo exists to protect the joy of homeownership. We believe that insurance should protect the things you treasure through an intuitive, modern experience. We provide tailored insurance coverage and preventative maintenance plans that keep you protected throughout your homeowner journey. We’ll also help you find coverage for everything life brings—from auto to flood—reimagining how you care for your home.

About The Role

The Claims Examiner – Partner Programs owns the review, coverage determination, and authorization of commercial casualty and specialty claims that exceed our TPAs’ and Claim Administrators’ authority. You will hold settlement and reserve authority up to $250,000, render and document coverage positions, direct litigation strategy on litigated files, and provide technical direction to TPA claim handlers with limited supervision.

You will work across Commercial General Liability, Business Owners Policy, Excess Casualty, and specialty lines including Professional Liability, Cyber, Marine, Aviation, and Excess & Surplus. This is a carrier-side oversight role, not a desk adjusting role — the files come to you already worked up, and your job is to decide.

What You’ll Do: 

Coverage & Claim Authority

• Review claims submitted by TPAs and Claim Administrators and authorize reserves and payments that exceed their authority, up to your authority of $250,000
• Render, document, and defend coverage positions on CGL, BOP, Excess Casualty, and specialty claims, including attachment point and exhaustion analysis on excess layers
• Draft, review, and approve reservation of rights letters, coverage denial letters, and disclaimers, ensuring accuracy and consistency of coverage analysis across programs
• Set and adjust reserve levels based on exposure, and ensure changes are made on a timely basis
• Escalate exposures above your authority to the Claims Program Manager with a documented recommendation
• Review and approve TPA funding requests within authority
• Prepare notifications to underwriters and reinsurers for large or contentious claims

Litigation Management

• Direct litigation strategy on litigated files — select and oversee defense counsel, approve litigation plans and budgets, and monitor spend against them
• Set settlement authority ranges and negotiating positions ahead of mediation, arbitration, and settlement conferences
• Evaluate damages, liability, and comparative fault exposure to support resolution decisions
• Manage coverage litigation and declaratory judgment actions in partnership with Legal
• Direct the retention of experts and counsel where the file requires it

TPA Oversight

• Provide technical direction and guidance to TPA claim handlers to ensure proper investigation and timely, equitable disposition of claims
• Lead and participate in claim file audits to monitor TPA performance against program standards, and drive corrective action on findings
• Partner with TPAs on coverage analysis, seeking underwriting input where appropriate
• Identify patterns across program files that indicate handling, reserving, or documentation issues

Regulatory & Complaint Handling

• Respond to Department of Insurance complaints, drafting position statements and coordinating the supporting file record
• Support market conduct examinations, data calls, and regulatory audits
• Ensure claim handling complies with each state’s unfair claims settlement practices requirements and internal guidelines
• Identify and escalate extra-contractual and bad faith exposure
• Assist with preparation of reports for underwriting, agents, insureds, and state agencies

Communication & Partnership

• Provide clear, professional communication to TPAs, brokers, and program partners
• Issue timely claim correspondence, status updates, and regulatory notices
• Participate in claim reviews and provide updates to management
• Maintain proper documentation in claim management systems
• Contribute to team knowledge sharing and support the technical development of less experienced examiners

What You Bring

• 2-5 years of commercial claims experience, including at least 3 years handling litigated commercial casualty claims
• Hands-on claims experience in Commercial General Liability (CGL) and Business Owners Policy (BOP)
• Experience in one or more specialty lines: Professional Liability, Cyber, Marine, Aviation, or Excess & Surplus (E&S)
• Excess Casualty or commercial umbrella experience, including attachment points and exhaustion of underlying limits
• Demonstrated claim authority at or near $250,000, or readiness to hold it
• Proven ability to render and document coverage positions independently — coverage analysis, reservation of rights, and denial letters
• Litigation management experience: defense counsel selection and oversight, litigation budgets, mediation and arbitration
• Experience responding to Department of Insurance complaints and supporting market conduct examinations
• Experience working with TPAs, program business, or delegated claims authority
• Ability to operate with limited supervision and sound judgment on high-exposure files
• Strong written and verbal communication — your coverage letters and position statements are the work product
• Adjuster licensing in required states, or the ability to obtain it
• Proficiency in Microsoft Office (Excel, Word, Outlook)

Nice to Have

• Fronting or program carrier experience, including evaluation of delegated claims authority
• Multi-state All Lines adjuster licensing
• AIC, SCLA, ARM, or CPCU designation
• Experience building or revising claim handling guidelines for a program
• Experience with claims in both admitted and non-admitted markets

Benefits and Perks

Hippo treats its team members with the same level of dedication and care as we do our customers, which is why we’re fortunate to provide all of our Hippos with:

• Healthy Hippos Benefits - Multiple medical plans to choose from and 100% employer covered dental & vision plans for our team members and their families. We also offer a 401(k)-retirement plan, short & long-term disability, employer-paid life insurance, Flexible Spending Accounts (FSA) for health and dependent care, and an Employee Assistance Program (EAP)
• Equity - This position is eligible for equity compensation 
• Training and Career Growth - Training and internal career growth opportunities
• Flexible Time Off - You know when and how you should recharge
• Little Hippos Program - We offer 12 weeks of parental leave for primary and secondary caregivers
• Hippo Habitat - Snacks and drinks available for onsite employees 

The Morristown, NJ base pay range for this role is $85,000 - $120,000. Exact compensation may vary based on several job-related factors that are unique to each candidate, including but not limited to: skill set, experience, education/training, location, business needs and market demands.

Hippo is an equal opportunity employer, and we are committed to building a team culture that celebrates diversity and inclusion. 

Hippo’s applicants are considered solely based on their qualifications, without regard to an applicant’s disability or need for accommodation. Any Hippo applicant who requires reasonable accommodations during the application process should contact the Hippo’s People Team to make the need for an accommodation known.