Claims Counsel

Claims Counsel Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home United States Reporting To: Michelle Edborg Compensation: $115,000 - $135,000 / year Description This role is responsible for managing and resolving high‑severity, complex insurance claims across a range of liability and specialty lines, including complex casualty, environmental, and surety exposures, with a strong emphasis on coverage analysis, policy interpretation, and strategic claim resolution. The position serves as a key subject‑matter expert for coverage issues, advising internal teams and carriers on high‑liability matters, regulatory exposures, and technically complex losses, 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, including environmental, construction‑related, and financial risk exposures. Key Responsibilities Coverage Analysis Review and interpret insurance policies, endorsements, and applicable statutes to determine coverage and exclusions. Draft and issue coverage position letters, including reservation of rights and denial letters, ensuring clarity and compliance with legal standards. Evaluate and update coverage forms as needed by carrier. Claims Investigation & Strategy Manage the investigation and resolution of high‑exposure and technically complex claims, including environmental contamination, construction defect, professional liability, and surety‑related matters. Oversee investigations involving engineering reports, environmental studies, financial documentation, and expert analysis to assess liability, damages, and potential recovery opportunities. Develop and implement strategic claim resolution plans, including coordination with defense counsel, coverage counsel, and technical experts. Provide carriers with detailed claim evaluations based on coverage analysis, independent investigation, and expert/legal opinions. Negotiation & Settlement Evaluate and make settlement recommendations, including obtaining and setting reserves within carrier guidelines. Negotiate settlements within authority limits, balancing legal risk and business objectives. Attend mediations, arbitrations, and hearings as required. Regulatory Compliance Ensure all claims handling complies with Department of Insurance regulations and company protocols. Maintain accurate documentation in the claims management system, including legal analyses and strategic recommendations. Types of Claims Handled Complex Casualty & High-Exposure Liability – Catastrophic injury, multi‑party liability disputes, and claims involving significant financial exposure. Environmental Liability – Pollution events, environmental contamination, remediation obligations, regulatory enforcement actions, and claims involving federal and state environmental statutes. Surety & Financial Risk – Performance and payment bond claims, contractor default, construction project disputes, and indemnity enforcement. Construction & Infrastructure Losses – Construction defect, contractor liability, engineering failures, and large‑scale project claims. Professional Liability – Claims involving errors and omissions, professional negligence, and complex service‑related liability exposures. Coverage Disputes & Declaratory Actions – Claims involving significant coverage interpretation issues, layered insurance programs, and disputes requiring legal analysis and strategic resolution. Skills, knowledge & expertise Required (one of the following): Juris Doctor (JD) with active bar membership in good standing. Also required: Relevant certifications (e.g., claims adjuster licenses) and willingness to obtain additional licenses, if needed. 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 complex liability lines. Experience working closely with coverage counsel or in‑house legal teams. Prior involvement in excess, umbrella, or specialty claims environments. Benefits Medical, dental, and vision plans to ensure your health and that of your family. A 401(k) plan with employer matching to help you build a secure financial future. Time‑off policies, including discretionary time off for exempt employees and Paid Time Off (PTO) for non‑exempt employees. Paid holidays. Life insurance and both short‑term and long‑term disability plans. Massachusetts Notice It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. #J-18808-Ljbffr