Under limited supervision, the Senior Complex Claim Professional is an individual contributor who investigates, evaluates, negotiates, and resolves the highest complexity litigated and non-litigated claims across multiple lines of business, including General Liability, Products Liability, and Professional Liability. The ideal candidate possesses expert-level coverage knowledge and embraces and advances Best Practices claims handling to industry and company standards, procedures, and objectives.
- Welcome working in a team-oriented collaborative environment with other seasoned Claim Professionals
- Exhibit expert-level knowledge of the claims process, best practices, and litigation management
- Active and affable contributor to the claim process, roundtables, and pre-trial calls to share knowledge and advance skills of others
- Analyze and identify coverage issues, prepare coverage letters with expert level coverage knowledge, and collaborate with in-house coverage counsel
- Investigate, evaluate, document, and reserve, assessing liability and damages according to Best Practices
- Manage litigation by assigning counsel from the approved panel where applicable, establish litigation plan and budget, coordinate with defense counsel, and continuously review for potential resolution.
- Establish timely reserves and continuously re-evaluate their adequacy upon receipt of new information
- Maintain timely and appropriate file documentation and written file notes
- Maintain an active diary and productive file inventory
- Timely completion of all required large loss reporting
- Negotiate settlements within authority, and attend mediations, mandatory settlement conferences, and/or Alternative Dispute Resolutions
- Possess a proactive approach to claim resolution and cost controls
- Develop and maintain positive customer relationships and provide superior customer service
- Timely identify and pursue all potential opportunities for co-insurance, risk transfer and/or subrogation
- Recognize and investigate suspected fraudulent claims
- Comply with deductible/self-insured retention and recovery protocols
- Meet all State licensing requirements
- Adhere to all statutory regulations, Unfair Claims Practices acts, and corporate Best Practices
- Serve as mentor and contributor for claims associates; provide technical advice
- Assist management with project-oriented work, presentations, and administrative tasks as needed
Other duties as assigned