Senior Casualty Claims Specialist

MSIG Holdings•Cincinnati, OH

About The Position

MSIG USA is the US-based subsidiary of MS&AD Insurance Group Holdings, Inc., a global property and casualty insurance group. The Senior Casualty Claims Specialist manages and resolves highly complex and high-severity liability claims, including litigated matters and coverage disputes. The role investigates claims, analyzes coverage and liability, evaluates damages and exposure, sets appropriate reserves, and negotiates timely and equitable resolutions under company guidelines, regulatory requirements, and Fair Claims Practices Acts. The position protects insureds and the Company’s financial and reputational interests through sound claim strategy, effective litigation management, accurate documentation, and responsive service to insureds, claimants, brokers, Underwriting, Home Office personnel, and other stakeholders. The specialist also supports client-facing claim reviews and meetings, maintains regulatory compliance and adjuster licensing, reports significant claim developments to senior stakeholders, and participates in departmental initiatives.

Requirements

Bachelor’s degree or equivalent experience.
Generally, seven to ten years of experience handling complex liability claims, including General Liability and Excess claims, high-severity, coverage-sensitive, and litigated matters.
Demonstrated expertise in coverage analysis, liability and damages evaluation, reserving, litigation management, and claim negotiation.
Must maintain applicable adjuster licenses and continuing education requirements.
Strong analytical, investigation, negotiation, problem-solving, and decision-making skills.
Ability to interpret insurance contracts, legal documents, regulations, and complex factual information.
Strong written and verbal communication skills, including the ability to present claim strategies and recommendations to senior stakeholders.
Strong computer skills, including Microsoft Word and Excel, and the ability to learn claim processing and document management systems.
Ability to work independently, prioritize competing demands, and manage complex claims with limited supervision.
Same-day and overnight travel may be required, up to 15%.

Nice To Haves

Juris Doctor (J.D.).
AIC, SCLA, CPCU, or other relevant insurance designation.

Responsibilities

Investigate, evaluate, and manage highly complex or high-severity General Liability and Excess claims, including coverage analysis, liability determinations, damages assessments, and legal issues affecting exposure.
Establish and maintain appropriate case reserves; resolve claims within designated authority and recommend reserve or settlement actions for matters exceeding authority.
Develop and execute claim strategies that support timely, fair, and equitable resolutions in accordance with company guidelines and jurisdictional requirements.
Manage litigated files by assigning matters to approved defense counsel, providing strategic direction, monitoring performance and outcomes, and complying with the Litigation Management Program.
Review legal invoices and claim expenses for accuracy, reasonableness, and compliance with applicable guidelines.
Attend mediations, settlement conferences, pretrials, and trials as required.
Identify, analyze, and communicate coverage issues and disputes in accordance with Company coverage guidelines.
Maintain timely and accurate claim file documentation, evaluations, reports, and system activity throughout the life of each claim.
Provide responsive, professional claim service to insureds, claimants, brokers, and business partners, and proactively communicate claim status.
Support client-facing activities, including claim reviews, presentations, and partnership meetings with Underwriting and distribution teams.
Build effective working relationships with Home Office personnel, defense counsel, vendors, and other stakeholders.
Ensure compliance with applicable state and federal regulations, Fair Claims Practices Acts, and MSMM Claim Handling Guidelines and procedures.
Submit accurate and timely data and reports to regulatory agencies and internal stakeholders as required.
Maintain active adjuster licenses and complete applicable continuing education requirements.
Prepare and deliver regular updates to Home Office and senior stakeholders regarding significant claim developments, exposure, and resolution strategy.
Participate in special projects, process improvements, and departmental initiatives as assigned.