Claims Litigation Specialist

Job Summary

Claims Litigation Specialist resolves litigation claim assignments requiring specialized knowledge of different lines of insurance business, litigation, and related processes. The role works within broad limits and authority, determines coverage, investigates, analyzes, negotiates, and settles litigation claims. The role manages reserves throughout the life cycle of each claim, analyzes liability and damage issues including complex primary and excess claims, adheres to individual authority grants, statutory and regulatory requirements, fair claim practices and supports underwriting.

Job Responsibilities

• Investigates and determines if proper coverage exists for assigned litigation claims, obtains relevant facts, makes decisions on litigation claim resolution, evaluates complex damages, and reviews all work for accuracy, completeness, and soundness of assumptions.
• Determines value of physical damage, obtains documentation, recognizes exposures, oversees defense counsel, aids with monthly close process, evaluates claim facts, and negotiates settlements.
• Establishes and executes a disposition plan, establishes and reviews reserves, adheres to litigation management guidelines, manages legal expenses, and updates underwriting guidance on regulatory and legislative changes.
• Develops and maintains effective business relationships, assigns counsel, monitors work products, and partners with counsel to handle litigation claims efficiently.
• Completes reports, assists in reviewing invoices, adheres to authority grants, statutory and regulatory requirements, fair claim practices, and local compliance requirements.
• Follows collection results and trends, maintains an active diary of estimate review assignments, and completes accurate investigations and evaluations on complex employment practices liability insurance policies.
• Participates in litigation activities, negotiates settlements with claimants, vendors, attorneys, and other insurance companies, refers claims exceeding authority and maintains appropriate documentation.
• Ensures customer service excellence, maintains effective stakeholder communication, independently manages key operational activities, collaborates with business partners to make decisions in company's best interest.
• Remains current on industry topics, trends, processes, technology, best practices, shares knowledge, drives new policies, processes, and procedures, and travels as needed to cover assigned territory.
• Supports underwriting by participating in client meetings and making presentations, evaluates contract language, maintains well-documented file notes, and gathers facts to develop claims resolution strategies.
• May involve traveling on short notice or other daily driving duties as assigned regardless of location.

Job Qualifications

• 6+ years of experience in claims litigation handling or in a related field.
• Bachelor's degree in business or a related field and/or commensurate work experience.
• Valid driver's license and a driving record that conforms to company standards.

Location

Remote

Behavioral Competencies

• Senior Claim Law Associate (SCLA)
• Collaborates
• Customer focus
• Communicates effectively
• Decision quality
• Nimble learning
• Adjuster License

Technical Skills

• Business Process Improvement
• Claims Case Management
• Claims Auditing
• Data Analysis and Reporting
• Fraud Investigation
• Information Systems
• Risk Management
• Legal Analysis
• Claims Investigation
• Claims Litigation

This job description describes the general nature and level of work performed in this role. It is not intended to be an exhaustive list of all duties, skills, responsibilities, knowledge, etc. These may be subject to change and additional functions may be assigned as needed by management.