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Davies North America · 1 week ago

Claims Counsel - Complex Adjusting

United States

Full-time

Remote

Mid, Senior Level

$115K/yr - $135K/yr

Davies North America is a leader in innovation and professional services within the insurance sector. The Claims Counsel will manage complex insurance claims, focusing on legal analysis and compliance while collaborating with various stakeholders to ensure fair and efficient claim resolutions.

Financial ServicesInsurance

Responsibilities

Review and interpret insurance policies, endorsements, and applicable statutes to determine coverage and exclusions

Draft and issue coverage position letters, including reservation of rights and denial letters, ensuring clarity and compliance with legal standards

Evaluate and update coverage forms as needed by carrier

Oversee and conduct investigations, including gathering evidence, reviewing reports, and analyzing liability and damages

Develop and implement strategies for claim resolution, including overseeing litigation management when necessary

Provide carrier with evaluation of claims based on experience, independent investigation, and opinions received from outside experts and counsels

Evaluate and make settlement recommendations, including obtaining and setting reserves within carrier guidelines

Negotiate settlements within authority limits, balancing legal risk and business objectives

Attend in mediations, arbitrations, and hearings as required

Ensure all claims handling complies with Department of Insurance regulations and company protocols

Maintain accurate documentation in the claims management system, including legal analyses and strategic recommendations

Advise internal teams and carriers on legal aspects of claims, providing clear guidance and recommendations

Represent carriers in discussions with external counsel, policyholders, and other stakeholders

Qualification

Juris Doctor (JD)Insurance law expertiseInsurance coverage analysisClaims management systemsLegal research toolsAnalytical skillsNegotiation skillsCommunication skills

Required

Juris Doctor (JD) and active membership in a relevant State Bar in good standing

Experience in insurance coverage analysis, litigation, or claims handling

Strong knowledge of insurance policies, legal principles, and regulatory requirements

Exceptional analytical, negotiation, and communication skills

Proficiency in claims management systems and legal research tools

Ability to manage multiple complex claims independently and meet deadlines

Benefits

Medical, dental, and vision plans to ensure your health and that of your family.

A 401k plan with employer matching to help you build a secure financial future.

Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non-exempt employees.

Paid holidays.

Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.

Company

Davies North America

We deliver professional services and technology solutions across the risk and insurance market, including claims, underwriting, distribution, regulation, customer experience, human capital, digital transformation and change management.

Founded in 1984