Senior Coverage Attorney
Encova Insurance
Encova Insurance has an immediate opening for a Senior Coverage Attorney (business title: Senior Claims Coverage & General Counselor). This opportunity is available as a remote, home-based position or hybrid basis from our Columbus, Ohio office. Candidates working remotely must reside in one of the approved payroll states listed in this posting.
Are you a Referral?
If you know a current Encova Insurance associate and would like to apply as a referral, please encourage them to submit your referral information before you submit your application. You will receive an email with a direct URL link to the Job Posting of interest. Applying through this URL link will create your referral relationship for our Talent Acquisition Team.
Unique residence requirements are listed in each job posting, please review closely for details.
Encova is only able to employ associates who reside and work within specific U.S. states. Our current policies are based on the laws in states in which we are registered for payroll. Our current footprint includes:
Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, Wisconsin.
JOB OBJECTIVE
The Senior Claims Coverage & General Counselor serves as the Claims organization’s senior legal and technical resource for insurance coverage, claim handling practices, coverage litigation, regulatory matters, extra-contractual exposure, legal process support, and emerging legal issues. The role provides practical guidance across all lines of business to promote timely, consistent, and technically sound claim decisions and outcomes.
Partnering with Claims leadership, Legal, Underwriting, and outside counsel, this position strengthens coverage expertise and claim quality; supports product development and regulatory response; manages significant coverage disputes and related legal expense; and reduces appropriate reliance on outside coverage counsel. The role complements the Legal Department by providing claim-focused coverage, regulatory, and technical expertise within Claims, while coordinating and escalating matters requiring enterprise legal advice, company representation, privilege oversight, or Legal Department ownership.
ESSENTIAL FUNCTIONS
- Provide timely legal and technical guidance on complex commercial and personal lines coverage matters, balancing applicable law, fair claim handling, and business considerations.
- Analyze policy language, endorsements, exclusions, claim facts, and applicable law; guide coverage investigations; prepare coverage opinions and related legal analyses; and review coverage communications.
- Advise Claims leadership on dispute-resolution approaches, extra-contractual exposure, bad-faith allegations, claim handling concerns, and other legal risks affecting claim outcomes.
- Serve as Claims’ senior technical resource for significant coverage litigation and declaratory judgment actions.
- Partner with Claims leadership, Legal, and outside counsel to develop and execute litigation and resolution strategies, including pleadings, discovery, mediation, settlement, budgets, and trial preparation.
- Evaluate outside counsel performance and legal expense to improve outcomes, reduce duplication, and manage allocated loss adjustment expense.
- Guide Claims responses to Department of Insurance complaints, regulatory inquiries, coverage disputes, market conduct examinations, and other regulatory reviews involving Claims operations.
- Support responses to subpoenas, records and discovery requests, and other legal process involving claim files; coordinate with Legal on matters requiring enterprise advice, company representation, privilege oversight, or Legal Department ownership.
- Monitor regulatory developments and claim handling requirements, and develop guidance and training to promote compliance and consistent practices.
- Promote consistent, technically sound coverage positions and claim handling practices across all lines of business.
- Participate in roundtables addressing complex coverage, exposure evaluation, litigation strategy, reserving, settlement authority, and claim handling issues.
- Assist in the development and maintenance of claim handling best practices, technical standards, coverage guidance, templates, and playbooks.
- Identify recurring coverage issues, legal and regulatory developments, and claim trends requiring guidance, training, escalation, or operational change.
- Support quality assurance and file reviews focused on coverage analysis, judgment, documentation, and decision-making, and serve as a trusted advisor to Claims leaders and professionals.
- Partner with Claims leadership to identify technical development needs and incorporate lessons from coverage matters, litigation, complaints, and regulatory reviews into training.
- Develop and deliver technical training, coverage resources, and learning tools; mentor claims professionals and leaders to strengthen expertise and judgment in coverage analysis, claim handling, regulatory requirements, extra-contractual risk, and emerging legal issues.
- Monitor judicial, regulatory, legislative, and industry developments affecting insurance coverage and claim handling, and advise Claims leadership on legal, operational, and risk management implications.
- Partner with Legal on matters requiring coordination, escalation, enterprise legal guidance, or broader risk management consideration.
- Partner with Underwriting and Legal to share claim-based insights and emerging loss trends; evaluate proposed policy language, endorsements, and coverage provisions; and recommend appropriate product or policy modifications.
- Support Claims initiatives involving new tools, processes, or workflows where coverage interpretation, legal risk, regulatory requirements, or claim handling standards are implicated.
- Handle appropriate coverage opinions, legal research, correspondence, and claim-related consultation internally to reduce reliance on outside coverage counsel.
- Establish referral criteria for outside coverage counsel and Legal Department involvement, and maintain effective relationships with legal service providers.
- Evaluate law firm performance, staffing, strategy, budgets, results, and legal spend to improve outcomes, reduce duplication, and manage allocated loss adjustment expense.
- Partner with Claims leadership and Reinsurance stakeholders on significant losses, coverage issues, treaty interpretation, reporting obligations, recoverability considerations, and matters affecting reinsurer relationships.
OTHER FUNCTIONS
- Attend mediations, arbitrations, depositions, trials, regulatory meetings, and other proceedings as appropriate.
- Represent Claims on cross-functional committees, projects, and strategic initiatives.
- Participate in industry conferences, professional organizations, and continuing legal education activities.
- Perform other duties as assigned.
KNOWLEDGE, SKILLS & ABILITIES
- Juris Doctor degree from an accredited law school is required.
- Active license to practice law in at least one U.S. jurisdiction and in good standing is required.
- CPCU, AIC, SCLA, or other relevant insurance industry designations are helpful.
- Minimum of 10 years of experience involving insurance coverage analysis, insurance litigation, claim-related legal support, or comparable property and casualty insurance experience is required.
- Extensive knowledge of commercial and personal lines insurance coverage, policy interpretation, and claim handling practices is required. Multi-line experience involving commercial auto, general liability, property, workers’ compensation, personal lines, umbrella, professional liability, or specialty coverages is preferred.
- Experience serving as coverage counsel, claims counsel, claim center general counselor, or in a similar role is strongly preferred.
- Demonstrated experience preparing coverage opinions, reservation of rights letters, denial letters, and other coverage-related communications is required.
- Strong knowledge of coverage litigation, declaratory judgment actions, extra-contractual and bad-faith exposure, and applicable claim handling requirements is required.
- Knowledge of insurance regulatory matters, and legal processes including responding to Department of Insurance complaints, market conduct examinations, and subpoenas is required.
- Experience managing outside counsel, coverage litigation, and legal spending is preferred.
- Experience supporting underwriting or product teams in policy wording, endorsement development, or product review is preferred.
- Knowledge of reinsurance principles, reporting obligations, treaty interpretation, and recoverability considerations is preferred.
- Exceptional legal research, analytical, writing, communication, and presentation skills.
- Ability to translate complex legal and regulatory issues into clear, practical guidance for claims professionals and business leaders.
- Demonstrated ability to influence decisions, exercise sound judgment, and build effective partnerships across organizational levels and functions.
- Ability to manage multiple complex matters, prioritize effectively, and provide timely guidance in a fast-paced claims environment.
- Ability to handle confidential, sensitive, and potentially privileged matters with appropriate discretion and escalation.
- Experience developing and delivering technical training for claims professionals and leaders is preferred.
This position has been evaluated in accordance with the Americans with Disabilities Act. Encova Insurance makes every effort to reasonably accommodate disabilities to permit performance of the essential functions and candidates who need such accommodation are encouraged to seek it. This description reflects the nature and level of work performed by associates in this position. It is not an all-inclusive inventory of duties, responsibilities and qualifications required. It provides an accurate overview of the work and skills needed to perform this position. Because job content may change from time to time, Encova Insurance reserves the right to add and/or delete functions from this job as it deems necessary for business reasons.
Ready to join our team?
At Encova Insurance, we firmly believe that our associates drive our company's success by delivering unrivaled service to our customers. With success in mind, we make an ongoing effort to provide an environment that offers challenging, stimulating, and financially rewarding opportunities. Join us to discover a work experience where you can learn and grow to your fullest potential.
What you can expect from us
In addition to a competitive compensation package, we offer a comprehensive benefits package designed to support the well-being and growth of our associates. Available benefits (subject to any policy or plan changes) include, but are not limited to:
Health, Dental & Vision Insurance
Company-provided life and income protection plans
Eligibility to participate in a company incentive bonus program
401(k) Retirement Plan - 100% company match up to 7% on annual salary
Paid Time Off, Paid Holidays, and Floating Holidays
Flexible Work Arrangements - Hybrid and remote depending on the role
We believe that happy, healthy associates are the foundation of great work. Join us and thrive both professionally and personally.
Encova Insurance is an EOE/E-Verify employer.
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