The Senior Claims Specialist is responsible for the handling, investigation, evaluation, and resolution of complex Directors & Officers (D&O) and Employment Practices Liability Insurance (EPLI) claims for non-profit organizations.
This role requires deep technical expertise in claims-made coverage forms, strong analytical and negotiation skills, and a commitment to delivering exceptional customer service to insureds, brokers, and legal partners. Position will also provide guidance and feedback to the junior staff.
Claims Management
- Independently manage a portfolio of complex non-profit D&O and EPLI claims from initial notice through resolution.
- Conduct timely and thorough coverage analysis under claims-made policies, including interpretation of policy terms, conditions, exclusions, and endorsements.
- Evaluate liability, damages, and exposure to determine appropriate claim reserves and resolution strategies.
- Oversee and direct defense counsel, including litigation strategy, budgeting, and performance.
Coverage Analysis & Technical Expertise
- Apply advanced knowledge of claims-made policy structures, including reporting requirements, retroactive dates, and prior acts provisions.
- Analyze legal and factual issues across a variety of EPLI claims (e.g., discrimination, harassment, wrongful termination) and D&O exposures specific to non-profits (e.g., fiduciary duties, governance disputes).
- Issue clear, concise, and well-documented coverage correspondence, including reservation of rights and coverage determination letters.
Vendor & Stakeholder Management
- Partner closely with insureds, brokers, and internal underwriting teams to ensure coordinated claim handling.
- Retain and manage external vendors, including defense counsel, experts, and third-party administrators.
- Negotiate settlements effectively to achieve optimal outcomes while controlling costs.
Customer Service & Communication
- Provide responsive, professional, and empathetic service to policyholders and stakeholders.
- Clearly communicate claim status, coverage positions, and resolution strategies to both technical and non-technical audiences.
- Build and maintain strong relationships with brokers and insureds to enhance customer satisfaction and retention.
Compliance & Reporting
- Ensure all claims activities comply with internal guidelines, regulatory requirements, and best practices.
- Maintain accurate and timely claim file documentation and reporting.
- Participate in audits, peer reviews, and continuous improvement initiatives.
- Works with attorneys, account representatives, agents, and insureds regarding the handling and/or disposition of highly complex claims.