Assistant Vice President, Claims Program Manager
Hiscox USA
Assistant Vice President, Claims Program ManagerBuild a brilliant future with HiscoxThe Assistant Vice President, Claims Program Manager is responsible for leading the strategy, design, delivery, and governance of technical claims training and professional development across the US Claims organization.A primary responsibility of this position is to develop the coverage-analysis capabilities of File Handlers and Claims Leaders. The role will design and deliver practical training on the interpretation and application of both Commercial General Liability and Commercial Professional Liability policies, helping Claims employees identify coverage issues, conduct structured coverage analyses, document coverage positions, and communicate coverage decisions clearly and consistently.The AVP, Claims Program Manager will bring significant hands-on claims experience in coverage analysis, complex file management, litigation strategy, reserving, negotiation, and claim resolution. The successful candidate must be able to translate that experience into practical learning programs for both developing and experienced Claims Professionals.The position also owns the Claims onboarding framework, technical curriculum, facilitator model, training calendar, and professional development strategy. The role works closely with Claims Leaders, Quality Assurance, Compliance, Legal, panel counsel, and subject matter experts to ensure technical training remains aligned with Claims Best Practices, QA standards, regulatory obligations, and emerging claim trends. These responsibilities reflect the approved operating model for a dedicated Technical Claims Development leadKey Responsibilities:Coverage Analysis Training and DevelopmentDevelop and deliver technical training for File Handlers and Claims Leaders on the interpretation and application of Commercial General Liability and Commercial Professional Liability policies.Teach a consistent and disciplined approach to coverage analysis, including:Identifying potentially applicable coverage parts and insuring agreements.Evaluating whether allegations or claimed damages fall within the scope of coverage.Analyzing definitions, conditions, exclusions, endorsements, and policy limitations.Identifying material coverage issues and determining when additional facts or legal analysis are required.Evaluating defense and indemnity obligations.Identifying potential reservation of rights, partial coverage, allocation, and coverage-denial considerations.Documenting coverage analyses clearly and completely within claim files.Drafting and reviewing coverage communications, including reservation of rights and coverage-position letters.Communicating complex coverage conclusions to insureds, brokers, counsel, and internal stakeholders.Create practical coverage-analysis exercises using policy language, claim scenarios, pleadings, demand letters, and other claim-file materials.Facilitate coverage workshops, technical roundtables, case studies, and calibration sessions for File Handlers and Claims Leaders.Develop differentiated learning pathways for new File Handlers, experienced claim professionals, and Claims Leaders responsible for reviewing or approving coverage decisions.Reinforce sound professional judgment by teaching participants how policy language, applicable facts, relevant allegations, claim developments, and jurisdictional considerations affect the coverage evaluation.Partner with Legal, Compliance, Claims Leaders, and coverage subject matter experts to keep training current and technically accurate.Complex Claim and File Management TrainingDevelop and deliver technical training on effective claim-file management from initial assessment through resolution.Train File Handlers and Claims Leaders on:Initial claim evaluation and development of an appropriate handling strategy.Investigation planning and identification of information needed to evaluate coverage, liability, damages, and exposure.Timely and accurate claim-file documentation.Identification and escalation of complex coverage, severity, regulatory, or litigation issues.Development and maintenance of meaningful action plans.Reserve analysis and documentation.Effective diary and inventory management.Coordination with insureds, brokers, defense counsel, coverage counsel, experts, and other stakeholders.Compliance with Claims Best Practices, quality standards, and applicable regulatory requirements.Incorporate lessons from QA reviews, audits, coverage referrals, litigated matters, and emerging claim trends into technical training.Develop job aids, file-review tools, templates, and technical resources that reinforce consistent file-management practices.Litigation Management and Claim ResolutionDesign and deliver training on litigation management and effective resolution of Commercial General Liability and Commercial Professional Liability claims.Train File Handlers and Claims Leaders on:Early assessment of litigation exposure and resolution opportunities.Development of defense and litigation strategies.Selection, instruction, oversight, and evaluation of defense counsel.Litigation budgeting and management of legal expenses.Evaluation of liability, damages, coverage, and settlement value.Preparation for mediations, settlement conferences, and other resolution proceedings.Negotiation strategy and settlement authority presentations.Documentation of litigation strategy, significant developments, and resolution decisions.Coordination of coverage and defense strategies when material coverage issues are present.Facilitate case-based discussions that strengthen judgment, negotiation skills, and strategic decision-making.Partner with panel counsel and external training providers to supplement internal expertise on specialized litigation and coverage topics.Training Delivery and FacilitationPersonally deliver technical training to File Handlers and Claims Leaders through instructor-led, virtual, and practical learning formats.Translate complex policy language, legal concepts, and claim-handling principles into clear, practical instruction.Provide coaching and feedback that helps Claims Professionals strengthen their coverage analysis, file management, and claim-resolution skills.Develop facilitator guides, presentation materials, exercises, case studies, job aids, and technical reference materials.Determine which topics require live instruction and which can be converted into self-paced or on-demand learning.Coordinate targeted contributions from Claims AVPs, subject matter experts, panel counsel, and external providers while assuming direct ownership of recurring core instruction.Onboarding and Professional DevelopmentDevelop technical learning pathways for less experienced Claims Professionals.Support the continuing development of experienced File Handlers and Claims Leaders.Identify opportunities for advanced technical programming, professional designations, continuing education, external courses, and industry partnerships.Coordinate onboarding and development activities with the Claims Program Specialist to ensure technical and operational training operate as one cohesive program.QualificationsRequired:Significant commercial insurance claims experience, including hands-on responsibility for complex claims.Demonstrated experience analyzing coverage under Commercial General Liability and/or Commercial Professional Liability policies.Strong understanding of policy interpretation, coverage-position development, reservation of rights, and coverage communications.Substantial experience managing claim files involving litigation, complex coverage issues, or significant exposure.Demonstrated experience developing claim strategies, directing investigations, establishing reserves, coordinating with defense counsel, and resolving litigated matters.Demonstrated ability to train, coach, mentor, or develop Claims Professionals.Strong written and verbal communication skills, including the ability to explain complex policy language and claim concepts clearly.Strong presentation and facilitation skills.Demonstrated ability to build collaborative relationships with Claims Leaders, File Handlers, Legal, Compliance, Quality Assurance, defense counsel, and other stakeholders.Strong organizational, project-management, and curriculum-
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