Claims Coverage Counsel/Claims Coverage Administrator

Merchants Insurance Group•Town of Huntington, NY

6d•$100,000 - $160,000•Hybrid

About The Position

Merchants Insurance Group is seeking an experienced Claims Coverage Counsel or Claims Coverage Administrator for its Claim Legal Team in Melville, New York. The role is responsible for first- and third-party coverage review, analysis, and decisions for claims at all levels, including litigated claims. It prepares coverage opinions and position letters for complex coverage issues and disputes, and supports claims professionals in assessing risk transfer opportunities, priority of coverage, and tender strategies. The position assesses and directs coverage litigation strategy with outside counsel and claims professionals, including developing and carrying out plans through final resolution. It provides claim, policy, regulatory, and legal expertise to management, reviews policy forms for updates and compliance with state regulations, statutes, and case law, and trains claims staff on policy interpretation, investigation, regulatory compliance, and good-faith claims practices. Depending on qualifications, it may also provide legal support to underwriting, product development, and regulatory compliance programs; the posting specifies that this support is for JD candidates. The position follows a hybrid schedule requiring two full days per week in the Melville office, with flexibility to work remotely or in the office on the remaining days. The estimated salary range is $100,000–$160,000, depending on leveling and geography, with an equity component and comprehensive benefits.

Requirements

Minimum five years of insurance coverage experience and/or practicing attorney experience.
Minimum ten years of technical experience in complex coverage analysis.
High competency in insurance coverage analysis, policy construction, and legal research, with exemplary writing skills.
Proficiency with Westlaw or other legal research applications.
Experience with construction and labor law litigation coverage issues related to risk transfer.
Excellent written and oral communication and presentation skills, with the ability to transfer knowledge through formal and informal training.
Ability to communicate effectively across all levels of an insurance organization and build cross-departmental relationships.
Demonstrated creative problem-solving ability.
Excellent interpersonal skills and ability to lead and work cooperatively.

Nice To Haves

Juris Doctor degree and a license in good standing.
CPCU designation.
Prior leadership experience.

Responsibilities

Prepare coverage communications consistent with internal quality standards and applicable state regulations.
Collaborate with front-line claims professionals and managers on coverage analysis and the preparation or review of coverage position letters for complex issues or disputes.
Prepare coverage opinions and position letters for claims involving complex coverage issues or disputes.
Assist claims professionals with evaluating risk transfer opportunities, priority of coverage, and tender strategies.
Provide legal or coverage guidance to claims professionals handling declaratory judgment actions in which Merchants is a named party.
Assess and direct coverage litigation strategy with outside counsel and claims professionals, including developing and executing a plan through final resolution.
Direct outside counsel on litigation strategy.
Make first- and third-party coverage reviews, analyses, and decisions for claims at all levels, including litigated claims.
Provide claim, policy, regulatory, and legal expertise to management, including senior management, as appropriate.
Review policy forms for updates and revisions and ensure compliance with state regulations, statutes, and case law.
Lead and train claims staff on legal and coverage matters, including policy interpretation, investigative processes, regulatory compliance, and good-faith claims practices.
Provide claim legal support to underwriting and product development teams.
Assist regulatory compliance programs with supplementary research on statutes and regulations affecting the business.

Benefits

Welcoming and positive work environment.
Colleague appreciation events.
Flexible work arrangements, including flexible scheduling and summer hours.
Hybrid work schedule, with two full days per week in the office and flexibility to work the remaining days at home or in the office.
Competitive pay scale.
Generous paid time off package.
Health, dental, vision, life insurance, and short-term disability benefits.
401(k) employer match of 100% up to 6% of annual contributions, immediately 100% vested.
Company bonus program.
Tuition reimbursement.
Equity component.