[Hiring] Senior Complex Claims Consultant @Davies

Role Description

This role is responsible for managing and resolving high-severity, complex insurance claims with a strong emphasis on coverage analysis, policy interpretation, and strategic claim resolution. The position focuses primarily on Employment Practices Liability (EPL) and Professional Liability claims, with additional exposure to Businessowners Policy (BOP) and General Liability (GL) claims within program structures.

This role serves as a key subject matter expert for coverage issues, advising internal teams and carriers on complex liability matters and ensuring claims are handled in accordance with applicable laws, regulations, and company guidelines.

This role is well-suited for either an attorney with insurance coverage experience or a senior complex claims professional with deep expertise in EPL, Professional Liability, and related coverage lines.

Key Responsibilities

• Review and interpret EPL, Professional Liability (E&O), BOP, and GL policies, endorsements, and applicable statutes.
• Analyze coverage issues including wrongful termination, discrimination, harassment, wage and hour exposures, professional negligence, and bodily injury/property damage triggers under GL.
• Draft and issue coverage position letters, including reservations of rights and denial letters, ensuring clarity and compliance with legal and regulatory standards.
• Evaluate and provide input on coverage forms and policy language as needed by carriers.
• Oversee and conduct complex claims investigations involving employment-related allegations, professional services exposures, and occasional GL-related losses.
• Analyze liability and damages in matters involving back pay, front pay, emotional distress, punitive damages, and economic loss.
• Develop and implement strategic approaches for claim resolution, including oversight of litigation when necessary.
• Provide carriers with independent evaluations of claims based on investigation, experience, and input from outside experts and counsel.
• Evaluate exposure and make settlement recommendations, including setting and managing reserves within carrier guidelines.
• Negotiate settlements within authority limits, balancing legal risk, financial exposure, and business objectives.
• Participate in mediations and settlement conferences as required.
• Ensure all claims handling complies with Department of Insurance regulations and internal protocols.
• Maintain accurate and thorough documentation in the claims management system, including coverage analyses and strategic recommendations.
• Serve as a trusted advisor to internal teams and carriers on EPL, Professional Liability, and GL-related coverage issues.
• Act as the primary coverage and strategy resource in interactions with external counsel, policyholders, and other stakeholders.

Qualifications

• Juris Doctor (JD) with active bar membership in good standing, or
• 7–10+ years of senior-level experience handling EPL, Professional Liability, GL, or similar complex liability claims.
• Active adjuster licenses and willingness to obtain and maintain additional licenses, as needed.
• Demonstrated expertise in insurance coverage analysis and policy interpretation.
• Experience issuing or advising on coverage positions, including RORs and denials.
• Strong understanding of liability, damages, and litigation strategy.
• Experience managing high-frequency EPL programs and familiarity with panel counsel management and billing guidelines in EPL matters.
• Exceptional analytical, negotiation, and communication skills.
• Ability to manage multiple high-severity, complex claims independently.
• Proficiency with claims management systems and related tools.
• Background in EPL, Professional Liability, or mixed program business including BOP/GL exposure.
• Experience working closely with coverage counsel or in-house legal teams.
• Prior involvement in program business or specialty lines environments.

Benefits

• Medical, dental, and vision plans to support your health and that of your family.
• A 401(k) plan with employer matching.
• Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees.
• Paid holidays.
• Life insurance and short-term and long-term disability coverage.
• Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee’s primary work location.
• Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.