Claims Counsel

Overview

This role is responsible for managing and resolving high-severity, complex insurance claims across various liability and specialty lines, including complex casualty, environmental, and surety exposures. The position emphasizes coverage analysis, policy interpretation, and strategic claim resolution.

Serving as a subject matter expert on coverage issues, the role advises internal teams and carriers on high-liability matters, regulatory exposures, and technically complex losses, ensuring claims are handled in compliance with applicable laws, regulations, and company guidelines.

This position is suitable for an attorney with insurance coverage experience or a senior complex claims professional with deep expertise in policy interpretation and complex liability lines such as environmental, construction-related, and financial risk exposures.

Responsibilities

Coverage Analysis

• 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 legal compliance.
• Evaluate and update coverage forms as needed by carriers.

Claims Investigation & Strategy

• Manage investigation and resolution of high-exposure and technically complex claims, including environmental contamination, construction defects, professional liability, and surety-related matters.
• Oversee investigations involving engineering reports, environmental studies, financial documentation, and expert analysis to assess liability, damages, and recovery opportunities.
• Develop and implement strategic claim resolution plans, coordinating with defense counsel, coverage counsel, and technical experts.
• Provide carriers with detailed claim evaluations based on coverage analysis, independent investigation, and expert/legal opinions.

Negotiation & Settlement

• Evaluate and make settlement recommendations, including setting reserves within carrier guidelines.
• Negotiate settlements within authority limits, balancing legal risk and business objectives.
• Attend mediations, arbitrations, and hearings as required.

Regulatory Compliance

• 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.

Types of Claims Handled

• Complex Casualty & High-Exposure Liability: Catastrophic injury, multi-party liability disputes, and claims with significant financial exposure.
• Environmental Liability: Pollution events, environmental contamination, remediation obligations, regulatory enforcement actions, and claims involving federal and state environmental statutes.
• Surety & Financial Risk: Performance and payment bond claims, contractor default, construction project disputes, and indemnity enforcement.
• Construction & Infrastructure Losses: Construction defects, contractor liability, engineering failures, and large-scale project claims.
• Professional Liability: Errors and omissions, professional negligence, and complex service-related liability exposures.
• Coverage Disputes & Declaratory Actions: Significant coverage interpretation issues, layered insurance programs, and disputes requiring legal analysis and strategic resolution.

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 reservation of rights and denial letters.
• 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.

Preferred Qualifications

• Background in complex liability lines.
• Experience working closely with coverage counsel or in-house legal teams.
• Prior involvement in excess, umbrella, or specialty claims environments.

Compensation & Benefits

• Salary range: $115,000 - $135,000 per year.
• Medical, dental, and vision insurance plans.
• 401(k) plan with employer matching.
• Paid time off policies including discretionary time off for exempt employees and paid time off for non-exempt employees.
• Paid holidays.
• Life insurance and short-term and long-term disability plans.

Location

• Remote position based in the United States.

Note: This job description provides a general overview of typical responsibilities and qualifications. Actual duties may vary based on organizational needs.