Major Case Claims Consultant

The Hanover Insurance Group•Worcester, MA

3d•Remote

About The Position

The Major Case Consultant Specialized Claims role is a senior-level claims position responsible for the full lifecycle management of highly complex and high-value specialized claims. This includes the investigation, evaluation, negotiation, and resolution of claims that represent the company’s largest damage exposures and often involve intricate coverage issues. The position requires a high level of technical expertise and collaboration with professionals across various disciplines. Specialized claims handled in this role include, but are not limited to, large property, workers compensation, PIP, and casualty exposures such as employment-related practices, sexual offense, professional liability, extra contractual cases, advertising injury, reinsurance, toxic tort, and environmental claims.

Requirements

Bachelor’s degree preferred; equivalent experience accepted. JD preferred or equivalent legal/claims experience. Industry designations (e.g., CPCU, AIC) strongly preferred.
Extensive experience handling highly complex, high-value claims with significant legal, financial, and reputational exposure.
Recognized authority in negotiation and resolution of complex claims; able to shape best practices and influence outcomes.
Demonstrated expertise in analyzing policy coverage, legal liability, and regulatory frameworks across jurisdictions.
Proven ability to manage litigation strategy, direct counsel, and represent the company in trials, mediations, and arbitrations.
Experience mentoring others and contributing to the development of investigative techniques, compliance protocols, and claims handling standards.
Strong written and verbal communication skills; able to simplify complex information and handle sensitive issues with professionalism.
Skilled in selecting appropriate communication channels and demonstrating empathy across diverse stakeholder groups.
Ability to draft clear, factual, and objective work product without opinion.
Highly organized with proven ability to manage complex workflows, projects, and competing priorities.
Demonstrated time management and organizational skills; able to coach others in these areas.
Deep understanding of insurance principles, coverage interpretation, and jurisdictional requirements.
Strategic thinker with sound judgment; able to make informed decisions independently and assess financial implications.
Expert in identifying and mitigating legal, regulatory, and reputational risks.
Recognized for developing empathetic customer service strategies and delivering exceptional service.

Responsibilities

Independently lead investigations and manage the full lifecycle of highly complex, sensitive, and specialized claims.
Analyze coverage, liability, and financial exposure; develop tailored resolution strategies and negotiate high-value or contested claims.
Set activities, reserves, and authorize payments within high authority limits; manage litigation budgets and direct counsel payouts.
Coordinate with internal and external experts (e.g., forensic analysts, underwriters, legal counsel, contractors) to ensure thorough evaluations and resolution.
Identify and pursue risk transfer opportunities; manage suspicious claims and refer to Special Investigation Unit as needed.
Serve as a subject matter expert (SME) for consistent handling of large losses; provide consultation on claim strategies and co-adjust files to support development.
Ensure compliance across jurisdictions including licensing, forms, deadlines, and accounting; maintain accurate and complete claim records.
Protect personally identifiable information (PII) and promote best practices across the team.
Represent the company in litigation, mediations, settlement conferences, and arbitrations; provide large loss and reinsurance reporting to underwriting.
Lead cross-functional meetings and collaborate with underwriting, agents, vendors, and legal teams to drive consensus and resolve claims.
Identify coverage gaps and partner with product management to enhance offerings.
Mentor and support less experienced adjusters; evaluate training programs and recommend improvements.
Lead quality initiatives to streamline workflows; use data tools to analyze trends and correct inconsistencies.
Maintain strong time and desk management skills; prepare reports and contribute to special projects.
Attend industry events and continuing education seminars to stay current on best practices.
Tailor communication strategies for specialized claims and maintain regular updates with leadership.
Build and maintain strong relationships with customers and stakeholders.