Senior Casualty Claims Specialist
About The Position
The Senior Casualty Claims Specialist manages and resolves highly complex and high-severity liability claims, including litigated matters and coverage disputes. The role conducts investigations; analyzes coverage and liability; evaluates damages and exposure; establishes appropriate reserves; and negotiates timely, equitable resolutions in accordance with MSMM Claim Handling 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 investigates and manages General Liability and Excess claims, develops claim strategies, establishes reserves, and resolves matters within assigned authority. For litigated files, the role assigns approved defense counsel, provides strategic direction, monitors performance, reviews legal invoices and expenses, and attends mediations, settlement conferences, pretrials, and trials as required. The specialist communicates coverage issues, maintains complete claim records, provides responsive service and claim updates, and supports client-facing reviews and meetings. The position also ensures regulatory and company-procedure compliance, maintains required adjuster licenses and continuing education, submits required reports, and updates Home Office and senior stakeholders on significant claim developments, exposure, and resolution strategy. Participation in special projects and process-improvement initiatives may be assigned. Same-day and overnight travel may be required, up to 15%.
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.
- 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 presenting claim strategies and recommendations to senior stakeholders.
- Strong computer skills, including Microsoft Word and Excel, and 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, liability, damages, 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 to support timely, fair, and equitable resolutions under company guidelines and jurisdictional requirements.
- Manage litigated files by assigning 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 each claim.
- Deliver responsive, professional claim service to insureds, claimants, brokers, and business partners.
- Maintain proactive communication and provide claim status updates in line with regulatory and company expectations.
- Support client-facing 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.
- Comply with applicable state and federal regulations, Fair Claims Practices Acts, 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 on significant claim developments, exposure, and resolution strategy.
- Participate in special projects, process improvements, and departmental initiatives as assigned.
Benefits
- Comprehensive medical, dental, and vision coverage.
- 401(k) with a generous employer match and profit-sharing contribution.
- Wellness incentive program.
- Life and accidental death and dismemberment (AD&D) insurance.
- Flexible spending programs.
- Short-term and long-term disability plans.
- Paid time off program.
- Paid charitable leave.
- Paid parental leave.
- Tuition reimbursement program.
- Personal insurance (auto/homeowners) discounts.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
