Complex Claims Specialist III - D&O And FI E&O Insurance

TEKsystems•Dallas, TX

1d•$60 - $90•Remote

About The Position

We are seeking a fully remote D&O and FI E&O Complex Claims Consultant. This role involves managing an inventory of complex Public D&O and Financial Institutions E&O claims, which are generally multi-year and have significant loss exposure. The consultant will follow company protocols to manage and oversee all aspects of claim handling, including coverage determinations, investigations, and resolution strategies. This includes pursuing risk transfer, extensive negotiations, and complex litigation management. The role also ensures exceptional customer service by driving continuous improvements, providing professional and timely claims services, and achieving quality and cycle time standards.

Requirements

Expert knowledge of specialty insurance industry, products, policy language, coverage, and claim practices.
Excellent verbal and written communication skills with the ability to develop collaborative working relationships, articulate very complex claim facts, analysis and recommendations in a concise manner to senior management, as well as with external business partners and customers.
Demonstrated analytical and investigative mindset with critical thinking skills and ability to make sound business decisions, and to effectively evaluate and resolve ambiguous, complex and challenging business problems.
Extensive experience in leading complex negotiations, as well as developing and implementing resolution strategies.
Strong work ethic, with demonstrated time management, organizational skills, and an ability to work independently in a fast-paced environment.
Ability to drive results by taking a proactive long-term view of business goals and objectives.
Extensive experience interpreting D&O and E&O insurance policies and coverage.
Ability to partner with internal resources, oversee/manage outside counsel, and collaborate with other carriers.
Ability to lead multiple and shifting priorities in a fast-paced and challenging environment.
Knowledge of Microsoft Office Suite and ability to learn business-related software.
Demonstrated ability to value diverse opinions and ideas
claims process
insurance claim
property & casualty insurance

Nice To Haves

cpcu
Guidewire

Responsibilities

Draft coverage letters which will have a secondary review
File documentation and requirements
Manages an inventory of the complex Public D&O and Financial Institutions E&O claims, which are generally multi-year and have significant loss exposure, by following company protocols to manage and oversee all aspects of the claim handling, including coverage determinations, investigations, and resolution strategies which may include pursuit of risk transfer, extensive negotiations and complex litigation management.
Ensures exceptional customer service by driving continuous improvements for all aspects of the claim/account, providing professional and timely claims services, and achieving quality and cycle time standards.
Verifies coverage, sets and manages timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel as needed, estimating potential claim valuation, and following company's claim handling protocols.
Leads all activities involved with a focused investigation to determine compensability, liability and covered damages by gathering pertinent information, documenting statements from customers/ claimants, and working with experts, or other parties, as necessary to verify the facts of the claim.
Drives the resolution of claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
Establishes and manages significant claim budgets by identifying, selecting and actively managing appropriate resources, delivering high quality services, and coordinating all efforts leading to timely resolution of the claim/accounts.
Discovers and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making appropriate referrals to appropriate Claim, Recovery or SIU resources for further investigation.
Achieves quality standards by effectively managing each claim to ensure that all company protocols are followed, work is accurate and timely, all files are properly documented and claims are resolved and paid timely.
Prepares and presents high profile, complex information to senior leadership, customers, counsel, and others by effectively identifying high profile matters, developing executive loss summaries, coordinating and communicating resolution strategies and sharing relevant current events and case law.
Maintains subject matter expertise and ensures compliance with state/local regulatory requirements by following company guidelines, and staying current on insurance laws, regulations or trends for the specialized line of business, and may represent company in industry trade groups or other important events.
May assist with special projects as needed.
May perform additional duties as assigned.