Senior Claims Attorney, Healthcare

Help us insure it. Tokio Marine HCC is a global industry-leading specialty insurance group, backed by the strength and stability of the Tokio Marine Group. Offering over 100 classes of specialty insurance, we empower clients to pursue opportunities confidently through our “Mind Over Risk” philosophy. More than an insurance company, we are an organization built on innovation, unity, and trust.

About the role

Manages hospital professional liability, general liability, auto, and managed care claims that involve the investigation of coverage, evaluation of liability and damages, and resolution, including but not limited to negotiation of settlements for the Excess Healthcare line of business.

Responsibilities

• Proactively oversee all aspects of high exposure claims to minimize company risk of loss.
• Analyze and draft coverage letters while properly communicating coverage positions to insureds, brokers and agents.
• Conduct proactive claim investigations and maintain a diary applying best practices to all files.
• Set timely reserves and draft concise reports to leadership when authority is exceeded.
• Assign, direct, and closely monitor outside counsel and vendors as needed.
• Negotiate claim settlements and attend court hearings, including mediations, settlement conferences, and trials.
• Complete all required regulatory reporting.
• Conduct legal research and other miscellaneous legal matters.
• Present complex claims and emerging trends to claims leadership and underwriting, providing technical advice when warranted.
• Mentor and educate less experienced adjusters.
• Represent TMHCC at industry conferences as necessary to establish TMHCC as a market thought leader.
• Conduct insured audits, loss runs reviews, and produce reports to senior leadership.
• Aide in the development of claims systems and processes.

Travel requirements: regular travel (up to 50% of the time).

Requirements

• Doctor of Jurisprudence (JD) degree or a related field or the equivalent education and/or experience.
• State Adjusting Licenses as required.
• 5 years of relevant and progressive experience in handling medical professional liability claims throughout the United States. A preference will be given to those with prior litigation experience at an insurance defense law firm specializing in medical professional liability claims.
• Knowledge of most effective and efficient methods to get things done, with a focus on continuous improvement and innovation.
• Sound analytical skills, as well as strong decision-making and problem-solving aptitude.
• Exceptional communicator and able to make connections externally and internally.
• Flexibility and a willingness to learn and adapt to new developing processes, systems, and procedures.
• Excellent written and verbal communications skills with an emphasis on confidentiality, tact, and diplomacy.
• Knowledge of industry changes, legal updates, and technical developments related to applicable area of the Company’s business to proactively respond to changing legal environment.
• Intermediate to advanced proficiency and experience using Microsoft Office package (Excel, Access, PowerPoint, Word).

Benefits

• Competitive salary and comprehensive benefits package.
• Strong learning culture with ongoing development opportunities.
• Opportunities for growth and career advancement.
• Comprehensive medical, vision, and dental coverage, with eligibility beginning on your first day of employment.
• Basic life and disability insurance.
• 401(k) plan with 6% company match.
• 20 days of PTO, two floating holidays, approximately 11 paid holidays, and volunteer time off.
• Paid parental leave.
• Access to our award-winning wellness program, including mental health services, fitness network membership, and a complimentary Headspace subscription.
• Student loan matching program.
• Employee discount program.

An opportunity to do meaningful work and love what you do.

Pay

The pay range for this position is $157,000-$235,800, which includes geographic adjustments, where applicable.

About Us

Tokio Marine HCC is a leading specialty insurance group with offices in the United States, the United Kingdom, Europe, and other exciting locations. With the strength and stability that comes from being a member of the Tokio Marine Group, and more than fifty years of growth, profitability, and stability, we offer important insurance products that most people don’t even know exist. Every policy we write is special, enabling our clients to do amazing things.