Claims Coverage Counsel/Claims Coverage Administrator

Merchants Insurance Group•Buffalo, NY

2d•$100,000 - $145,000•Hybrid

About The Position

Merchants Insurance Group is seeking an experienced Claims Coverage Counsel or Claims Coverage Administrator for their Corporate Claim Legal Team in Buffalo, NY. This role involves preparing coverage opinions and letters for complex claims, assisting claims professionals with risk transfer, priority of coverage, and tender strategies. The position also directs coverage litigation strategy with outside counsel and claims professionals, and may provide legal support to underwriting, product development, and regulatory compliance programs. The role requires first- and third-party coverage review, analysis, and decision-making for all claim levels, including those in litigation. Additionally, it involves providing expertise to management, reviewing policy forms for compliance, and training claims staff on policy interpretation, investigation, regulatory compliance, and good faith claims practices.

Requirements

Juris Doctor degree preferred, with license in good standing
Minimum 5 years of insurance coverage experience and/or practicing attorney experience
Proficiency with Westlaw or other legal research applications
Minimum 10 years of technical experience in complex coverage analysis
High degree of competency in insurance coverage analysis, policy construction, and legal research with exemplary writing skills.
Ability to transfer knowledge through formal and informal training with demonstrated excellent written and oral presentation skills.
Advanced written and oral communication skills with influence, initiative, and ability to communicate effectively across all levels across an insurance organization to include cross-departmental relationships.
Experience with construction and labor law litigation coverage issues related to risk transfer.
Proven demonstration of creative problem-solving abilities.
Excellent interpersonal skills with the ability to lead and work in a cooperative manner.

Nice To Haves

CPCU highly desirable
Prior leadership experience is highly desired

Responsibilities

Prepares coverage communication consistent with internal quality standards and applicable state regulations.
Works collaboratively with front-line claims professionals and managers to provide coverage analysis and preparation or review of coverage position letters for claims involving complex coverage issues or disputes.
Provides legal or coverage guidance to claim professionals handling declaratory judgment actions in which Merchants is a named party.
Directs outside counsel on litigation strategy.
Leads claim staff in training involving legal or coverage matters.
Provides claim legal support to underwriting and product development teams.
Assists in regulatory compliance programs by providing supplementary research regarding statutes and regulations impacting our business.
Review all policy forms for updates and revisions, ensuring compliance with state regulations, as well as applicable statutes and case law.
Training for all levels of claims staff in matters of policy interpretation, investigatory processes, regulatory compliance and good faith claims practices across multiple venues.