Senior Technical Claims Specialist: Excess, Coverage and Specialized Claims

As the claims owner, determines coverage, investigates the claims, determines liability, sets and adjusts reserves, evaluates the claim, negotiates a settlement, authorizes and pays the claim; may deny claims. Review lawsuit documentation and supporting documents, claims file, investigation, etc. Establish actions to be taken to resolve lawsuit. Includes determining loss coverage, amounts owed, discovery plans, setting reserves and negotiations. Establish appropriate working team (Home Office Legal, Defense Counsel and Home Office Claims) based on allegations established in suit. Responsible for managing the practices and billing activities of outside counsel. Accountable for security of financial processing of claims, as well as security information contained in claims files. Trains and mentors staff as appropriate; manages relationships and acts as liaison with various business partners (e.g., Underwriting, Reinsurance, Etc.). Keeps abreast of existing and proposed legislation, court decisions and trends and experience pertaining to specialty coverage issues. May analyze the impact upon claims policies and procedures and advises Claims Management so appropriate action can be taken where required. Leads and participates in special projects and performs other duties as assigned. Bachelor's degree and 5 to 7 years claims adjusting experience. Advanced to expert knowledge of commercial casualty claims investigation, coverage, reserving, expense management, resolution strategy, negotiation, litigation management, claims evaluation as well as the insurance legal and regulatory environment. Advanced to expert level of skill in the area of customer focus, gaining support, teamwork, and adaptability. Expert ability to identify and solve problems, achieve results and execute thoroughly. Demonstrated ability to work independently, mentor other employees, and serves as a subject matter expert as normally acquired through 7 or more years of experience. Ability to adapt to work in multiple claim systems. Experience with Commercial Excess and Umbrella claims averaging $1-3 million or more required. Excess claims experience with Commercial General Liability, Premises Liability, Employers Liability, Environmental, Commercial Auto, Products Liability, mass torts and other Commercial Casualty Claims experience preferred.

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