Claims Specialist

Duties/Responsibilities:  

• Manage High-Exposure and Complex Claims: 

• Handle claims across Financial Lines (D&O, E&O, Cyber, Crime, Tech Liability) with high financial impact, ensuring efficient resolution while mitigating company exposure. 

• Conduct Coverage Analysis: 

• Review and interpret policy language, assess coverage applicability, and provide coverage determinations in alignment with legal and regulatory requirements. 

• Litigation and Dispute Management: 

• Oversee litigation strategies, work closely with external defense counsel, and participate in mediation, arbitration, and settlement negotiations. 

• Regulatory and Compliance Oversight: 

• Ensure claims handling practices comply with state, federal, and international regulations, particularly in emerging sectors such as blockchain and digital assets. 

• Collaborate with Underwriting and Risk Teams: 

• Provide insights on claims trends, risk assessments, and policy wording recommendations to enhance underwriting strategies and product development. 

• Work with External Partners: 

• Liaise with brokers, third-party administrators (TPAs), coverage counsel, and forensic investigators to facilitate claims investigations and resolutions. 

• Lead Claims Investigations: 

• Conduct in-depth claim assessments, including gathering evidence, interviewing key parties, and analyzing loss data to make well-informed claims decisions. 

• Develop and Implement Claims Strategies: 

• Establish proactive claims-handling strategies to optimize financial outcomes and improve policyholder experiences. 

• Provide Thought Leadership on Emerging Risks: 

• Stay ahead of market trends, regulatory developments, and industry best practices, particularly in financial lines and blockchain-related risks. 

• Deliver Reports and Stakeholder Communications: 

• Prepare detailed claim summaries, risk analyses, and reports for senior management, reinsurers, and regulatory bodies, ensuring transparency and strategic alignment. 

• Bachelor’s degree in Law, Business, Finance, Risk Management, or a related field required; Juris Doctor (JD) or advanced degree preferred. 

• 3-5 years of experience handling complex financial lines claims, including D&O, E&O, Cyber, Crime, and Technology Liability in an insurance, legal, or risk management setting. 

• Strong knowledge of insurance policy language, coverage analysis, and claims resolution strategies, particularly within financial and professional liability lines. 

• Experience managing high-exposure, litigated claims, including oversight of outside counsel, mediation, and settlement negotiations. 

• Familiarity with regulatory frameworks such as SEC regulations, GDPR, CCPA, AML/KYC compliance, and evolving digital asset insurance requirements. 

• Prior experience in blockchain, fintech, or emerging technology-related risks is highly desirable. 

• Proven ability to work with third-party administrators (TPAs), brokers, reinsurers, and risk management professionals to drive optimal claims outcomes. 

• Strong analytical, negotiation, and communication skills, with the ability to articulate complex coverage issues and claims strategies to internal and external stakeholders. 

• Adjuster license in all 50 states strongly preferred; ability to obtain additional state licenses as required. 

The annual salary for this role is structured within a range of USD$140,000 to USD$160,000, depending on experience and qualifications.