Senior Claims Consultant
Individual contributor responsible for the overall management of highly complex claims in a Specialty line of business. Recognized as a technical expert in the interpretation of complex or unusual policy coverages in area of expertise. Under general management direction, works within assigned limits of broad authority on assignments requiring a high degree of technical complexity and coordination. May have regional, industry segment or company-wide scope of responsibility within specialty area.
Essential Duties & Responsibilities
Performs a combination of duties in accordance with departmental guidelines:
1. Manages highly complex litigated matters, including analysis of coverage issues, liability and damages. Strong coverage acumen required in respect of a variety of policy forms, involving multiple coverages and coverage parts. Analyzes coverage issues, prepares coverage positions, and formulates claim strategy.
2. Independently assesses liability and damages based on investigation. Determines if a claim should be settled or litigated and formulates and executes on appropriate resolution/litigation strategy accordingly. Ability to handle high severity matters including class actions and complex corporate litigation, potentially including securities litigation.
3. Proactively retains counsel where necessary and manages outside counsel on litigated matters/claims to achieve optimal claim resolution. Effectively manages loss costs and claim expenses.
4. Manages all types of investigative activity or litigation on assigned claims, including the posting of appropriate reserves in a timely manner.
5. Directly negotiates and resolves cases where appropriate. Participates in mediations and settlement conferences to resolve files. Attends trials where necessary. Negotiates highly complex settlement packages, and authorizes payment within scope of authority, settling claims in most cost-effective manner and ensuring timely issuance of disbursements.
6. Coordinates third party recovery with subrogation/salvage unit.
7. Makes recommendations on claims processes and resolution strategies to management. Demonstrates strong verbal communication and writing skills. Prepares round table reports and presents claims to senior management and internal business partners. Prepares large loss reports for high severity claims.
8. Effectively communicates key claim information such as coverage positions, resolution plans, and exposures with insureds, brokers, actuaries, and underwriters. Strong soft skills and ability to influence key parties.
9. Works with attorneys, account representatives, agents, and insureds regarding the handling and/or disposition of highly complex claims.
10. Keeps current on state/territory regulations and issues, industry activity and trends. May participate in industry trade groups.
11. Provides guidance and assistance to less experienced claims staff and other functional areas.
12. Responsible for input of data that accurately reflects claim circumstances and other information important to our business outcomes.
May perform additional duties as assigned.
Manager or above.
Skills, Knowledge & Abilities
1. Advanced technical and product specific expertise, claims resolution skill and knowledge of insurance and claims principles, practices and procedures. Position requires demonstrated ability to handle litigated matters, including selection and direction of counsel, and formulation and execution of resolution strategies under duty-to-defend policies, and strategic coordination with counsel, insureds, brokers and even other insurers under reimbursement policies.
2. Strong communication, negotiation and presentation skills. Ability to effectively interact with all levels of internal and external business partners.
3. Advanced analytical and problem-solving skills, with the ability to manage and prioritize multiple projects.
4. Ability to think strategically; deal with ambiguous situations and issues.
5. Creativity in resolving unique and challenging business problems.
6. Knowledge of Microsoft Office Suite and other business-related software.
7. Ability to adapt to change and value diverse opinions and ideas.
8. Ability to manage and prioritize multiple projects.
9. Ability to evaluate claims based on a cost benefit analysis.
10. Ability to fully comprehend complex claim facts and issues; and to further articulate analyses of claims in presentations to business partners and management as well as in internal reports.
11. Ability to implement strategies with a proactive long-term view of business goals and objectives.
Education & Experience
1. Bachelor's degree or equivalent experience.
2. Typically a minimum eight years claims experience.
3. Licensed in New York
EEO Statement: Equal Opportunity Employer committed to a diverse work culture.
Primary Location United States
Organization Worldwide Claims