Excess Claims Consultant

Under the general supervision of the Claims Management, the Excess Claims Consultant investigates, evaluates, and resolves MPL and GL claims on a primary and excess basis with moderate to high degrees of complexity and severity. 

Essential Duties & Responsibilities

• Analyzes and verifies insurance coverage for claims brought against policyholders, including review and evaluation of policies issued by Coverys as well as policies and retentions that may be below or concurrent with Coverys coverage.

• Manage a pending comprised primarily of excess MPL claims.

• Maintains working knowledge of policy forms and components.

• Reviews pleadings and other claim documents and analyzes all applicable policies to determine scope and application of coverage, including indemnity, defense, and any applicable cost-sharing.

• Interviews insureds, insured representatives, claimants, experts, and other appropriate parties to obtain information used to assess liability and potential exposure. 

• Consults medical or other relevant records pursuant to investigation of claims.

• Prepares reports on established diary dates and other specific reports as needed to appropriately document investigations, evaluations, strategies, negotiations, and resolutions, and provide necessary updates to reinsurers and other business partners.

• Considers necessary and appropriate consultants and experts to facilitate understanding of cases, and to support liability, causation, and damages defense.

• Communicates and works collaboratively with insureds, defense counsel and claims representatives from other carriers representing our insureds and codefendants.

• Timely evaluates and adjusts indemnity and expense reserves within authority and makes reserve recommendations to Manager/Director for amounts over authority.

• Monitor and engage underlying coverage layers to develop exposure and encourage behavior of underlying risk holders.

• Determines and implements negotiation strategies and negotiates settlements within authority, including direct negotiations with plaintiff counsel.

• Advises Claim Director, Claim VP, and/or Claim SVP regarding claims status.

• Ensures timely reporting to and presents cases to Reserve & Settlement Committee meetings, as necessary.

• Evaluates cases for appropriate disposition and seeks authority for settlement from Manager/Director when settlement requests exceed authority.

• Directs and monitors activities of defense counsel in compliance with guidelines.

• Utilizes and evaluates defense budgets to ensure effective, efficient expenditures on defense.

• Monitors trials and attends pre-trial proceedings, mediations, and arbitrations, as necessary.

• Identifies significant insured Risk Management or Underwriting issues and directs the information to the appropriate department.

• Interacts with other departments as necessary to help facilitate and coordinate services to our insureds.

• Any other essential duties/functions, as needed.

Education, Experience, Competencies & Values

• Bachelor’s degree from four-year college or university

• J.D. preferred, with at least 5 years’ experience dealing with serious bodily injury claims on an excess, umbrella, and/or reinsurance basis.  

• Good working knowledge of medical, legal, and insurance terminology is required.

• Experience with insurance policy review and application to litigation.

• Experience with UK market and shared and layered exposure helpful.

• Ability to recognize and assess excess claim exposures.

• Strong written and oral communication skills, including ability to draft reports, business correspondence, and technical case summaries, and including comfort with presentations to senior leadership, insureds, and internal and external customers.

• Ability to effectively present information and respond to questions from groups of managers, insureds, agents, and attorneys.

• Able to synthesize complex or diverse information; collect and research data; use intuition and experience to complement data; design workflows and procedures.

• Strong organizational skills and ability balance multiple projects and competing priorities.

• Ability to work independently and in a collaborative team environment.

• Able to design and generate creative solutions.

• Insurance adjuster’s license(s) may be required.

• Travel as needed to regional claims offices, customer locations, and trials, mediations, and/or settlement conferences.  Travel approximately 10%.

The base salary range is $85,000 - $115,000. Individual compensation packages are based on a variety of factors that are unique to each candidate including geographic location, skill set, experience, qualifications and education.

If you're a caring and customer focused individual who enjoys working with passionate team members, Coverys is the right company for you!