Claim Counsel – D&O/Professional Liability

Responsibilities

• Review and interpret insurance policies, endorsements, and applicable statutes to determine coverage, exclusions, and obligations.
• Draft and issue coverage position letters, including reservations of rights and denial letters, ensuring clarity and compliance with legal and regulatory standards.
• Evaluate and provide input on coverage forms and policy language as needed by carriers.
• Oversee and conduct complex claims investigations, including gathering evidence, reviewing reports, and analyzing liability and damages.
• Develop and implement strategic approaches for claim resolution, including oversight of litigation when necessary.
• Provide carriers with independent evaluations of claims based on investigation, experience, and input from outside experts and counsel.
• Evaluate exposure and make settlement recommendations, including setting and managing reserves within carrier guidelines.
• Negotiate settlements within authority limits, balancing legal risk, financial exposure, and business objectives.
• Participate in mediations and settlement conferences as required.
• Ensure all claims handling complies with Department of Insurance regulations and internal protocols.
• Maintain accurate and thorough documentation in the claims management system, including coverage analyses and strategic recommendations.
• Serve as a trusted advisor to internal teams and carriers on coverage and complex claims issues.
• Act as the primary coverage and strategy resource in interactions with external counsel, policyholders, and other stakeholders.

Requirements

• Juris Doctor (JD) with active bar membership in good standing, or
• 7–10+ years of senior‑level experience handling complex liability claims.
• Adjusters licenses
• Demonstrated expertise in insurance coverage analysis and policy interpretation.
• Experience issuing or advising on coverage positions, including RORs and denials.
• Strong understanding of liability, damages, and litigation strategy.
• Exceptional analytical, negotiation, and communication skills.
• Ability to manage multiple high‑severity, complex claims independently.
• Proficiency with claims management systems and related tools.
• Background in professional liability, directors & officers coverages, or other complex liability lines (preferred).
• Experience working closely with coverage counsel or in‑house legal teams (preferred).
• Prior involvement in excess, umbrella, or specialty claims environments (preferred).
• Core Competencies

Demonstrates expertise in insurance coverage analysis, policy interpretation, and complex claims management, with a strong focus on compliance with legal and regulatory standards.

Proficient in negotiation and strategic claim resolution, ensuring effective communication with internal teams and external stakeholders.

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