Senior Complex Claims Specialist- MPL
About The Position
Our Senior Complex Claims Specialist role is an individual contributor role responsible for the handling of Miscellaneous Professional Liability claims for the organization from inception to resolution. This involves the negotiation and settlement of mid to high severity Miscellaneous Professional Liability insurance claims. May be responsible for single or multi-country claims and will be responsible for all aspects of the claims, including liaise with external and internal business partners (e.g., outside experts and/or or legal counsel; underwriting) as required. The Senior Complex Claims Specialist is the most senior technical role in the organization. This person adjudicates assigned claims within given authority and provides operational support to the claims team. This person also: With minimal supervision, adjusts to resolution the highest severity claims and drafts the most complex technical coverage analysis and letters required in the given claim department Acts as subject matter expert within the team Leads litigation best practices and strategy including attending and leading trials and mediations Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions Identifies and provides potential solutions for emerging exposures and claims trends Identifies suspected fraudulent claims and tracks with special investigations unit Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities Mentors other team members Develops content and conducts training for claims team and underwriters as requested Reviews and analyses claim documentation and legal filings
Requirements
- 10+ years of claims handling experience.
- A JD from an ABA accredited law school may be considered as a supplement to claims handling experience
- Proven ability to positively affect highest severity claims outcomes through investigation, negotiation and effectively leading litigation
- Expert knowledge of coverage within the team’s specialty or focus
- Expert knowledge of litigation process and negotiation skills
- Proven track record of mentoring others
- Excellent verbal and written communication skills
- Advanced analytical skills
- B.A./B.S degree from an accredited College or University preferred
- Adjuster licensing is required or ability to obtain within 90 days of employment
Nice To Haves
- Subject matter expertise or technical leadership in other lines of business and/or claim types
- Demonstrates ability to work with minimal oversight
- Demonstrates ability to advance product innovation or develop a greater understanding of other aspects of the business through training or other relevant projects across teams of lines of business
- Demonstrates courage in addressing and solving difficult or severity matters with insureds, attorneys and brokers
- Demonstrated steps taken toward additional certifications by an approved authority such as a CPCU, ARMS or AINS designation
- Commitment to professional development and learning demonstrated by at least 10 hours of continuing education related to insurance topics through Success Factory, Hiscox in-person or video conference training sessions, or other in-person seminars or webinars
Responsibilities
- Adjusts to resolution the highest severity claims and drafts the most complex technical coverage analysis and letters required in the given claim department
- Acts as subject matter expert within the team
- Leads litigation best practices and strategy including attending and leading trials and mediations
- Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions
- Identifies and provides potential solutions for emerging exposures and claims trends
- Identifies suspected fraudulent claims and tracks with special investigations unit
- Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities
- Mentors other team members
- Develops content and conducts training for claims team and underwriters as requested
- Reviews and analyses claim documentation and legal filings
Benefits
- 401(k) with competitive company matching
- Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)
- Company paid group term life, short- term disability and long-term disability coverage
- 24 Paid time off days plus 2 Hiscox days,10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO days
- Paid parental leave
- 4-week paid sabbatical after every 5 years of service
- Financial Adoption Assistance and Medical Travel Reimbursement Programs
- Annual reimbursement up to $600 for health club membership or fees associated with any fitness program
- Company paid subscription to Headspace to support employees’ mental health and wellbeing
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What This Job Offers
Job Type
Full-time
Career Level
Senior
