Associate, Business Insurance Claims

Business Insurance Claims Advocate

Ideal candidate would have a solid understanding of Commercial Property, Inland Marine, Business Continuity and / or Stock Throughput (STP) coverage knowledge that will be used to advocate for clients resulting in the best possible resolution of their claims.

Under minimal supervision of the Director of Business Insurance Claims, this position is responsible for servicing clients through claims advocacy and management of claims.

Develop and maintain client relationships through advising and providing advocacy on Business Insurance claims and related coverage issues. Perform claim reviews and status updates to ensure that claims are properly set up, coverage positions are received, reserves are adequately set, and that the claim files are moving towards closure or resolution in a timely manner. Provide routine status updates to service team on open claims. Communicate with claim professionals, clients, and internal staff, and achieve successful results.

Essential Duties & Responsibilities

Provide effective claims management and advocacy.

Develop and maintain computer based task system of events and diary of routine status updates for claims including dates critical to ensuring claims are properly set up, a timely coverage position is issued, a claims adjuster is assigned, defense counsel is assigned (when applicable), and status update of claims progress. Actively manage assigned claims independently and present claims to service teams and clients.

Participate in and provide advocacy on claim strategy, and consult on a regular basis with defense counsel and clients to assist in claim strategy, settlement discussions and resolution of large and complex claims. Actively coordinate claims with multiple or excess / umbrella carriers.

Independently participate and present successfully oral and written claims at client claim reviews in a professional manner and demonstrate added value and advocacy of claims for coverage lines including, claims activity summaries, identifying facts of the claim, status of the matter, key claims issues and concerns as it applies to applicability of coverage, and develop a strategy.

Review and summarize coverage positions, including evaluation of coverage denials and reservations of rights, as to appropriateness and present analysis and recommendations to client.

Develops and drafts claim rebuttals and explanations of applicability of coverage provisions of policies for all coverage lines.

Review, strategize and make recommendations of next steps for claims as well as complex claims involving multiple carriers or layers, and large loss claims.

Identify and consult when claims intervention is necessary and advocate on behalf of clients to reduce reserves and successfully resolve disputed / denied claims or resolve claims through strategic claims management.

Identify and address steps which can be taken to transfer risk and / or subrogate claims, including contract and indemnity evaluation.

Participate in new business sales presentations.

Independently handle and manage World Class Accounts and ability to present orally and in writing to defense counsel, general counsel and management level positions in a clear and concise manner.

Evaluate the facts of matters as they apply to contracts and policy obligations.

Evaluation and assess liability and damages, including ability to identify and as necessary recommend strategic steps to minimizing risk or exposure. Ability to independently assess, identify and recommend in connection with a client or defense counsel experts, social media, surveillance, medical and pre-existing injuries and other strategies to minimize liability and damages, and other risk transfer strategies.

Service clients through claims management.

Develop and maintain computer based calendaring system of events for clients, including critical dates for claims reviews and tasks.

Maintain client claim files and provide updates as needed or agreed on with clients or producers.

Maintain and document claim files, including summarizing coverage positions and claim strategies.

Maintains active claim file diary and claim notes.

Establish and develop client and company relationships to provide the most effective claims handling.

Participate in sales and service calls at the request of producers and clients, advising clients the ways in which MMA can assess liability, monitor claim handling to ensure appropriate handling by carriers and address steps which can be taken to transfer risk and / or subrogate claims.

Ensure key internal associates and clients are apprised of claim status :

Develop working relationships with dedicated claim liaisons from insurance carriers to support the most effective way to handle claims successfully.

Monitor claim files and obtain routine status updates, including providing regular status updates to service teams. Respond to requests for updates or questions from the service team or clients.

Identify and notify producers and service teams of large complex claims, claims that have potential coverage obstacles, denied or disputed claims and your strategy to work with the adjuster to resolve issues.

Establish and develop client and company relationships to ensure good communication for the most effective claims handling.

Assist on developing and working with leadership and management to ensure that claims resources are deployed in the most efficient manner and to support the claims team role as coverage advocates.

Take on assignments and duties as requested by the Director of Business Insurance Claims.

Education and / or Experience

Successful candidate will be a service oriented individual with high personal standards and a hands-on work style. This position requires an individual who is comfortable working at a varying pace, managing multiple tasks and deadlines simultaneously, adjusting priorities often, and managing frequent interruptions. This position requires in person client presentations with ability to communicate with general counsel and management.

In addition, the following is required unless otherwise noted :

Successful work history to include 4 years of experience in a professional office setting directly related to job responsibilities.

Must have law degree (J.D.) from accredited law school and have practiced for over 2 years in litigation, or advanced paralegal certificate with over 10 years' experience in complex civil litigation including trials.

Demonstrated commitment to continuing education including development through licensing or designations applicable to property and liability insurance field is preferred.

Proficient in Westlaw or Lexis legal research software.

Maintain skills and knowledge through independent study, seminars and educational industry resources available for claims management or other job specific specialty areas.

Proficiency with personal computers, internet and Microsoft Office applications (i.e., Word, Outlook Excel and PowerPoint) with the ability to operate standard office equipment.

Skill in organizing resources and establishing priorities.

Demonstrated ability to independently resolve problems and present results neatly, with clarity and precision in oral and written form.

Ability to independently present to clients in new business and existing relationships complex claims and services.

This position interacts with and provides services to a large group of internal associates and has high levels of contact with external vendors and clients. The Associate must be positive and approachable, and work effectively with diverse personalities.

Demonstrated ability to develop, plan, and implement short- and long-range goals.

Maintain a valid Driver's License and have reliable transportation.

Work Environment & Physical Demands

Ability to use computer keyboard and sit in a stationary position for extended periods.

Work is performed in a typical interior / office work environment.

30% - 45% travel may be required. Travel consists of 1 15 overnight trips per year both in and out of state. In addition, 3-4 days per week are spent visiting clients at their offices.

Extended work hours (10 12 hrs / day) required on occasion due to client meetings and industry functions that begin well before the workday.