Liability Major Case Specialist - New York City, NY

What Is the Opportunity?

This position investigates, evaluates, reserves, negotiates and resolves assigned serious and complex Specialty claims. It involves providing quality claim handling throughout the claim life cycle, maintaining compliance with internal and external quality standards, and state-specific regulations. The role also includes consulting and training, serving as an expert technical resource, and managing litigated claims.

What Will You Do?

• Directly handle assigned severe claims with direct damage value ranging from $500,000 to several million dollars.
• Provide quality customer service and ensure file quality, timely coverage analysis, and communication with insureds based on policy information.
• Investigate claims through strategic contacts with policyholders, account managers, claimants, law enforcement, witnesses, agents, medical providers, and technical experts.
• Interview witnesses and stakeholders, take necessary statements, and complete outside investigations as needed.
• Engage in the identification, selection, and direction of appropriate internal and/or external resources for specific activities like subrogation, risk control, nurse consultants, and fire or fraud investigators.
• Verify the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation.
• Maintain claim files and document activities in accordance with established procedures.
• Develop and employ creative resolution strategies and manage litigated claims.
• Evaluate liability and damages exposure and establish and maintain proper indemnity and expense reserves.
• Recommend appropriate cases for discussion at roundtables and attend or present at these meetings.
• Apply claim quality management protocols and metrics, and provide guidance to underwriting business partners.
• Perform other duties as assigned.

Minimum Education Required

Bachelor's Degree. 10+ years claim handling experience with 5-7 years experience handling serious injury and complex liability claims.

Additional Qualifications/Responsibilities

• Extensive working level knowledge and skill in various business line products.
• Excellent negotiation and customer service skills.
• Advanced skills in coverage, liability, and damages analysis with expert understanding of the litigation process in both state and federal courts, including relevant case and statutory law and procedure; expert litigation management skills.
• Four years bodily injury litigation claim handling experience or comparable claim litigation experience.
• Thorough understanding of commercial lines products, policy language, exclusions, ISO forms, and effective claims handling practices.
• Demonstrated strong coaching, influence, and persuasion skills.
• Advanced written and verbal communication skills to understand, synthesize, interpret, and convey complex data and information to audiences with varying levels of expertise.
• Openness to the ideas and expertise of others and actively solicits input and shares ideas.
• Strong technology aptitude; ability to use business technology tools to effectively research, track, and communicate information.
• Analytical Thinking - Advanced.
• Judgment/Decision Making - Advanced.
• Communication - Advanced.
• Negotiation - Advanced.
• Insurance Contract Knowledge - Advanced.
• Principles of Investigation - Advanced.
• Value Determination - Advanced.
• Settlement Techniques - Advanced.
• Litigation Management - Advanced.
• Medical Terminology and Procedural Knowledge - Advanced.