Internal Coverage Counsel – Claims

About the role

We are a team of employees dedicated to delivering best-in-class customer service and innovation in the industry. Our commitment to integrity, relationships, and excellence drives us to ensure that every aspect of our work is of the highest standard.

Key Responsibilities Of The Role

• Supports operational teams and senior management by providing timely, consistent, and defensible coverage guidance aligned with policy intent and claim handling best practices.
• Serves as a centralized internal resource for coverage interpretation, promoting consistency across claim teams, jurisdictions, and lines of business.
• Communicates clearly and proactively with Claims, Underwriting, Insurance Product, and other stakeholders to enable effective risk decisions and reduce friction created by inconsistent coverage positions.
• Promotes sound legal governance, including appropriate management of attorney-client privilege and documentation practices in claims and coverage consultations.

Claims Coverage Support

• Provides legal analysis and guidance on personal lines and complex commercial lines claims involving coverage questions, including interpretation of forms, endorsements, exclusions, conditions, tenders, additional insured issues, and priority/other insurance disputes.
• Reviews and standardizes key coverage correspondence, including reservations of rights, coverage position letters, denial letters, non-waiver agreements, and tender response communications.
• Conducts targeted legal research and prepares written coverage assessments and recommendations for claim professionals and leadership, including identification of escalation triggers and extra-contractual exposure considerations.
• Develops and maintains reusable work product (templates, playbooks, issue-spotting tools, and guidance notes) to improve quality and speed of coverage decisioning.
• Implements and supports an intake, triage, and prioritization approach for coverage requests; establishes service expectations and feedback loops with claim teams.
• Manages the use of outside counsel for novel, high complexity, or high exposure coverage matters; scopes assignments appropriately, enforces budget discipline, and captures lessons learned for internal knowledge sharing.
• Delivers training to claim professionals on recurring coverage issues, quality documentation, and best practices for defensible coverage communications.

Insurance Product and Underwriting Support

• Provides coverage and form interpretation support to Insurance Product and Underwriting on personal lines and commercial lines to enable consistent underwriting intent and claim outcomes.
• Participates in form and endorsement reviews, offering recommendations to improve clarity, reduce ambiguity, and minimize preventable coverage disputes.
• Identifies recurring coverage issues and claim dispute drivers and communicates actionable insights to Product and Underwriting, including opportunities for wording clarification or process improvements.
• Participates in cross-functional working sessions to align coverage interpretation, underwriting strategy, and claims handling practices as the organization grows or expands into new markets.

Claims Compliance Support

• Provides targeted guidance to support regulatory compliance, audit readiness, and adherence to claims handling standards, including documentation, timeliness, and required notices.
• Supports Medicare-related and other claims compliance obligations as applicable by providing process guidance and training to reduce operational risk.
• Aids in the development of practical compliance tools and reference materials that improve consistency and reduce avoidable handling defects.

Required Qualifications

• Juris Doctor (J.D.) from an accredited law school.
• Active license and good standing to practice law in at least one U.S. jurisdiction.
• 8 years of experience in insurance coverage, claims legal support, and/or insurance litigation with substantial commercial lines property and casualty exposure.

Preferred Qualifications

• Prior in-house experience at a property and casualty insurer supporting claims operations and/or insurance product teams.
• Familiarity with multi-state claims handling requirements and both personal and commercial lines coverage trends.
• Insurance industry designation(s) (e.g., CPCU) or other relevant credentials.