Claim Counsel - D&O/Professional LiabilityDepartment: Claims Administration & Adjusting
Employment Type: Permanent - Full Time
Location: Home United States
Reporting To: Michelle Edborg
Compensation: $110,000 - $135,000 / year
DescriptionThis role is responsible for managing and resolving high-severity, complex insurance claims with a strong emphasis on coverage analysis, policy interpretation, and strategic claim resolution. This role serves as a key subject matter expert for coverage issues, advising internal teams and carriers on complex liability matters and ensuring claims are handled in accordance with applicable laws, regulations, and company guidelines.
This role is well-suited for either an attorney with insurance coverage experience or a senior complex claims professional with deep expertise in policy interpretation and complex liability lines.
Key ResponsibilitiesCoverage Analysis- 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.
Claims Investigation & Strategy- 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.
Negotiation & Settlement- 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.
Regulatory Compliance & Documentation- 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.
Collaboration & Communication- 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.
Skills, knowledge & expertiseRequired (one of the following):- Juris Doctor (JD) with active bar membership in good standing, or
- 7-10+ years of senior-level experience handling complex liability claims.
Also required:- 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.
Preferred:- Background in professional liability, directors & officers coverages, or other complex liability lines.
- Experience working closely with coverage counsel or in-house legal teams.
- Prior involvement in excess, umbrella, or specialty claims environments.
BenefitsAt Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:
- Medical, dental, and vision plans to support your health and that of your family
- A 401(k) plan with employer matching
- Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees
- Paid holidays
- Life insurance and short-term and long-term disability coverage
Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee's primary work location.
Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.
