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About the Role

Leads and directs a team of claims professionals handling Reinsurance and Open Market cyber, media, and technology error and omissions claims and litigation. Manages claims, as well as claims staff, in other areas, including Miscellaneous Professional Liability, Employment Practices Liability, and other specialty liability insurance products. Ensures the claims staff is following company procedures and that benefits are paid to those who are eligible. Analyzes and reviews legal pleadings, documents, and applicable statutes to determine validity of liability claims.

Responsibilities

Supervise and direct a team of claims professionals handling primarily Cyber, Media, and Technology Errors & Omissions claims and manage team workflow.
Coordinate work activities of the team.
Responsible for development and coaching of staff to maximize proper handling.
Build a team-oriented environment by establishing team and individual goals through empowerment.
Coach and mentor direct reports and provide training opportunities.
Educate and train team members in the duties and responsibilities of best claims practices.
Review and evaluate the performance of personnel and define goals.
Perform quality reviews on claims in compliance with internal and external audit requirements.
Communicate with internal and external stakeholders, including insureds, brokers/agents, and insurance carrier clients, and provide exceptional customer service.
Provide in depth coverage analysis and wording interpretation.
Conduct investigations and evaluate liability to determine validity of complex claims.
Provide oversight to direct reports with regard to formulation and issuance of coverage position letters, negotiation and resolution of claims, and decision-making within defined authority through delegation and empowerment.
Prepare and draft complex legal correspondence to affected parties.
Maintain electronic claim files.
Update files as needed.
Oversee all aspects of the litigation process for high-exposure liability claims to minimize company risk of loss.
Negotiate claim settlements within defined authority limit.
Recommend and present proposed claim resolution and/or settlement terms to management for claims that are in excess of the defined authority limit.
Develop and maintain processes and procedures for the team in coordination with Claims Department Management.
Recommend and implement techniques to improve productivity and efficiency and cut costs.
Oversee outside counsel and vendors related to claims handling responsibilities.
Keep current on state regulations with issues, industry activities, and trends.
Attend settlement conferences, mediations, and facilitation hearings on the Company’s behalf as needed.
Provide supervision and guidance to less experienced Claims personnel including the review of settlement payments and denials but obtain appropriate authority to issue denials.
Provide timely and accurate reporting to management and other internal clients including summaries of open/closed claims or other related bordereaux.
Support Claims Department Management and Underwriting unit as needed.
Obtain and maintain claims adjuster’s licenses or other professional designations as required by the Company.
Oversee the payment of claims on the basis of the coverage of the insurance customer, the proof of damage, and an insurance appraisal.
Ensure that all claims are valid according to the company policy and consult with legal representation when necessary.
Review and respond to claim referrals and questions from claims staff.
Review and respond to claim appeals and grievances.
Perform claims reviews and makes recommendations based on policy provisions and processing guidelines.
Prepare and present reports on claims performance, trends, and operational efficiencies to senior management.

Requirements

Has full HR responsibility for direct reports including making hiring decisions, training, coordinating work, establishing standards, reviewing work, conducting performance appraisals, and providing coaching or counseling.
Comply with all corporate policies and procedures.
Identify control objectives for designated function and implement cost effective controls designed to meet those objectives.
Test controls to determine if they are performing as intended.
Lead business process improvement for the department.
Develop and is accountable for budget of the department.
Perform cost benefit analyses for the department.
Communicate team or group plans or results at all organizational levels.
Prepare written and verbal presentations that educate and inform on area of responsibility/expertise.
Write, or is a major contributor to, management/technical reports or contractual documents.
Develop and implement short-term and long-term plans to improve business processes for department.
Coordinate resources to ensure strategies are executed.

Skills

Advanced knowledge
Strong leadership skills
Claims handling
Cyber, Media, and Technology Errors & Omissions
Coverage analysis
Wording interpretation
Litigation oversight
Negotiation
Process development
Productivity improvement
Cost reduction
Outside counsel management
Vendor management
Regulatory compliance
Reporting
People management
HR responsibility
Hiring decisions
Training
Performance appraisals
Coaching
Counseling
Business process improvement
Budget management
Cost-benefit analysis
Corporate policy compliance
Control implementation
Control testing
Communication
Presentation skills
Technical writing

Location

Remote

Work Type

Hybrid
Full-time

Experience Level

Management

Salary/Compensations

$146,900-$220,300

Benefits

Competitive salary
Employee benefit package
Strong learning culture
Growth perspectives
6% 401K match
20 days of PTO
2 Floating Days
Paid parental leave

About the Company

Tokio Marine HCC (TMHCC) brings 50 years of service to the specialty insurance industry, today offering over 100 products to commercial customers in 180 countries around the world.
Every policy we write is special, enabling our clients to do amazing things.
From insuring the crops that feed us to the rock concerts that entertain us, to rescuing international travelers in trouble.
Organic growth and over 60 successful acquisitions have grown our 2023 Gross Written Premium (GWP) to over $7.5 Billion.
Our workforce has grown to 4,300 worldwide … big, but not so big that you cannot make a difference.
Our Good Company values, including integrity, empowerment, and commitment to customer service, and a culture of innovation, communication, and collaboration make TMHCC a great place to work.
Applying our Mind Over Risk philosophy to writing insurance allows our customers to take on opportunity with confidence.
That philosophy defines our way of thinking, unites us as a team, and differentiates us from our competitors.
We are much more than just an insurance company; we are a good company.

Equal Opportunity

TMHCC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to age, ancestry, citizenship, color, family or medical care leave, gender identity, genetic information, marital status, medical condition, national origin, physical or mental disability, protected veteran or military status, race, ethnicity, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable local laws, regulations and ordinances.
The Company will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e))(the “VCCLEA”), which restricts financial institutions and insurers such as TMHCC from employing individuals with certain types of criminal convictions.
Where the hiring and employment of individuals is not restricted by the foregoing, the Company will consider qualified applicants with arrest or conviction history in compliance with applicable law such as the California Fair Chance Act, the Los Angeles Fair Chance Initiative for Hiring Ordinance, the Los Angeles County Fair Chance Ordinance, the San Diego Fair Chance Ordinance, and the San Francisco Fair Chance Ordinance.
As an insurance company, we comply with certain federal, state and local laws such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e)), which restricts our ability to employ individuals with certain types of criminal convictions.
Where not restricted by law and for criminal history not covered by this law, the Company will consider qualified applicants with arrest or conviction history in compliance with applicable law.
You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you.
After making a conditional offer and running a background check, if the Company is concerned about a conviction that is directly related to the job, you will be given the chance to explain the circumstances surrounding the conviction or challenge the accuracy of the background report.