Senior Complex Claims Consultant / Claims Counsel
Core
Managing and resolving high-severity, complex insurance claims with a focus on coverage analysis, policy interpretation, and strategic resolution for EPL and Professional Liability.
Role type
Senior Complex Claims Consultant / Claims Counsel
Builds
Strategic claim resolutions and coverage positions for carriers and policyholders
Domain
Insurance / Liability Coverage (EPL, Professional Liability, GL)
Required skills
Coverage analysis, Policy interpretation, Liability assessment, Damages analysis, Litigation strategy, Settlement negotiation, Reserve management, Claims investigation, Regulatory compliance, Stakeholder advisory
Preferred skills
Juris Doctor (JD), Active bar membership, Adjuster licenses, Panel counsel management, Program business experience
Technologies
Claims management systems
Responsibilities
Review and interpret EPL, Professional Liability, BOP, and GL policies; Analyze coverage issues including wrongful termination and professional negligence; Draft coverage position letters and reservations of rights; Evaluate liability and damages involving back pay and punitive damages; Develop strategic approaches for claim resolution and oversee litigation; Negotiate settlements and manage reserves; Participate in mediations and settlement conferences; Ensure compliance with Department of Insurance regulations.
Seniority
Senior, hands-on IC