Complex Claim Director
Triton CMS for Programs · United States · 3 days ago
RemoteRemoteFinanceFull-time
The Complex Claims Director will manage high-exposure transportation and casualty claims involving significant financial, legal, and reputational risk. This position is responsible for handling the most complex commercial auto, trucking, logistics, cargo, general liability, construction, hospitality, and habitational claims from initial notice through final resolution. The ideal candidate will possess extensive experience in complex casualty claim management, coverage analysis, litigation oversight, large-loss investigations, and strategic claim resolution. This individual will serve as a technical resource for clients, internal stakeholders, and claims professionals while maintaining a strong focus on claim quality, cost containment, customer service, and regulatory compliance. The successful candidate demonstrates deep expertise in commercial transportation and casualty exposures, strong negotiation and litigation management skills, and the ability to independently manage severe and catastrophic claims involving complex liability and coverage issues. Essential Duties & ResponsibilitiesComplex Claims Management Manage a portfolio of high-severity and complex casualty claims, including: Commercial Auto Liability Trucking & Transportation Cargo & Logistics General Liability Construction Defect Hospitality Habitational Property Damage Catastrophic Injury and Fatality Claims Excess and Umbrella Liability Claims Oversee the entire claim lifecycle from first notice of loss through settlement, litigation, arbitration, trial, or closure. Conduct detailed liability, damage, and exposure evaluations utilizing industry best practices. Establish and maintain appropriate reserves based on claim exposure and evolving case facts. Identify and implement proactive strategies that drive timely and equitable claim resolution. Prepare comprehensive large-loss reports and claim analyses for internal leadership, clients, carriers, and excess partners. Coverage Analysis & Technical Expertise Analyze complex policy language and coverage provisions. Draft and review reservation of rights, excess exposure, coverage position, and denial letters. Interpret contractual indemnity obligations, hold harmless agreements, additional insured endorsements, and risk transfer provisions. Evaluate and address coverage disputes, declaratory judgment actions, and extra-contractual exposure. Provide technical expertise and guidance on complex casualty and transportation claims. Litigation Management Retain, direct, and manage defense counsel, coverage counsel, experts, and investigative vendors. Develop litigation strategies designed to achieve favorable claim outcomes and minimize exposure. Monitor legal budgets, litigation expenses, and vendor performance. Attend mediations, settlement conferences, arbitrations, depositions, and trials as required. Evaluate legal liability, damages, venue considerations, and potential verdict exposure. Manage significant claims involving severe injury, wrongful death, catastrophic loss, and multi-party litigation. Investigation & Resolution Lead complex investigations to determine liability, damages, coverage applicability, and recovery opportunities. Analyze accident reconstruction reports, police reports, expert findings, medical records, and financial damages. Evaluate catastrophic transportation losses involving multiple vehicles, cargo, environmental impacts, and property damage. Negotiate settlements directly with claimants, attorneys, insurers, brokers, and business partners. Client & Stakeholder Management Serve as a trusted advisor for customers, carriers, brokers, insureds, and internal leadership. Communicate claim strategy, exposure analysis, and resolution recommendations to key stakeholders. Partner closely with clients to develop effective claim management and litigation strategies. Respond to escalated claim matters and provide technical consultation on complex files. Operational Excellence & Continuous Improvement Ensure compliance with company standards, regulatory requirements, and industry best practices. Maintain timely and accurate documentation, diary management, and reporting standards. Monitor claim trends, litigation developments, and emerging transportation exposures. Assist in developing claims best practices, training materials, quality assurance initiatives, and operational improvements. Contribute to organizational initiatives focused on claim quality, customer satisfaction, cost management, and process optimization. Serve as a subject matter expert and mentor for less experienced claims professionals. QualificationsRequired Bachelor's Degree or equivalent experience. 10+ years of casualty claims experience with significant exposure to complex and litigated claims. Extensive experience handling: Commercial Auto Liability Trucking and Transportation Claims Cargo Claims General Liability Construction Claims Hospitality Risks Habitational Risks Excess and Umbrella Liability Claims Demonstrated success handling large-loss and catastrophic claims involving severe bodily injury, wrongful death, and substantial property damage. Strong experience managing coverage issues and litigation strategy. Adjuster license(s) or ability to obtain required licenses. Preferred Juris Doctor (JD) designation. CPCU, AIC, SCLA, ARM, or equivalent industry designation. Experience managing excess, surplus lines, and specialty casualty claims. Experience working within a TPA, insurance carrier, or large transportation risk environment. Experience overseeing complex reserve portfolios and high-exposure litigation. Core CompetenciesTechnical Expertise Coverage Analysis & Policy Interpretation Transportation & Trucking Claims Commercial Auto Liability Cargo & Logistics Claims General Liability & Construction Claims Catastrophic Loss Management Litigation Management Excess & Umbrella Claims Risk Transfer Analysis Reserve Adequacy & Exposure Assessment Professional Skills Advanced Analytical and Problem-Solving Skills Strategic Decision-Making Negotiation and Conflict Resolution Influencing and Stakeholder Management Effective Written and Verbal Communication Organizational and Time Management Skills Sound Judgment Under Pressure Customer Service Excellence Leadership Attributes Subject Matter Expertise Mentorship and Peer Development Continuous Improvement Mindset Accountability and Ownership Collaboration and Teamwork Results-Oriented Performance