Overview
This role is responsible for managing and resolving high-severity, complex insurance claims with a strong emphasis on coverage analysis, policy interpretation, and strategic claim resolution. It serves as a key subject matter expert for coverage issues, advising internal teams and carriers on complex liability matters and ensuring claims are handled in accordance with applicable laws, regulations, and company guidelines.
The position is suitable for either an attorney with insurance coverage experience or a senior complex claims professional with deep expertise in policy interpretation and complex liability lines.
Responsibilities
- 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 carriers.
- Oversee and conduct investigations, including gathering evidence, reviewing reports, and analyzing liability and damages.
- Develop and implement strategies for claim resolution, including overseeing litigation management when necessary.
- Provide carriers with evaluations of claims based on experience, independent investigation, and opinions received from outside experts and counsel.
- 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.
- Advise internal teams and carriers on legal aspects of claims, providing clear guidance and recommendations.
- Represent carriers in discussions with external counsel, policyholders, and other stakeholders.
Requirements
- Juris Doctor (JD) with active bar membership in good standing, or
- 7–10+ years of senior-level experience handling complex liability claims (e.g., commercial auto/trucking, general liability, excess/umbrella, professional liability).
- 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 commercial trucking or other 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 (PTO) 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 depending on organizational needs.