Review and interpret insurance policies, endorsements, and applicable statutes to determine coverage and exclusions.
Draft and issue coverage position letters, including reservation of rights and denial letters, ensuring clarity and compliance with legal standards.
Evaluate and update coverage forms as needed by carrier.
Manage the investigation and resolution of high-exposure and technically complex claims, including environmental contamination, construction defect, professional liability, and surety-related matters.
Oversee investigations involving engineering reports, environmental studies, financial documentation, and expert analysis to assess liability, damages, and potential recovery opportunities.
Develop and implement strategic claim resolution plans, including coordination with defense counsel, coverage counsel, and technical experts.
Provide carriers with detailed claim evaluations based on coverage analysis, independent investigation, and expert/legal opinions.
Evaluate and make settlement recommendations, including obtaining and setting reserves within carrier guidelines.
Negotiate settlements within authority limits, balancing legal risk and business objectives.
Attend mediations, arbitrations, and hearings as required.
Ensure all claims handling complies with Department of Insurance regulations and company protocols.
Maintain accurate documentation in the claims management system, including legal analyses and strategic recommendations.
Requirements
Juris Doctor (JD) with active bar membership in good standing.
Relevant certifications (e.g., claims adjuster licenses) and willingness to obtain additional licenses, if needed.
Demonstrated expertise in insurance coverage analysis and policy interpretation.
Experience issuing or advising on coverage positions, including RORs and denials.
Strong understanding of liability, damages, and litigation strategy.
Exceptional analytical, negotiation, and communication skills.
Ability to manage multiple high-severity, complex claims independently.
Proficiency with claims management systems and related tools.
Background in complex liability lines (preferred).
Experience working closely with coverage counsel or in-house legal teams (preferred).
Prior involvement in excess, umbrella, or specialty claims environments (preferred).
Benefits
Medical, dental, and vision plans to ensure your health and that of your family.
A 401k plan with employer matching to help you build a secure financial future.
Our time-off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
Paid holidays.
Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.