Job Summary
The Complex Claims Specialist adjudicates assigned Media Professional Liability and Miscellaneous Professional Liability claims – covering exposures such as accountants and tax preparers, property managers, real estate agents, consultants, actuaries, insurance agents, trustees, and similar professions. This high-level adjuster role handles all phases of complex litigation, provides operational support to the broader claims team, and mentors less experienced examiners. Caseloads average 110-120 files (80%+ litigated), with authority to manage individual claims up to $150K and exposure levels up to $2M.

Responsibilities

• Adjudicate and resolve complex-to-severe MPL and media liability claims nationwide, including all phases of litigation (investigation, negotiation, trial preparation, and resolution).
• Draft detailed coverage letters (reservation of rights, denials, etc.) with minimal supervision, ensuring legal and policy accuracy.
• Review and analyze claim documentation, pleadings, and legal filings to inform strategy and coverage decisions.
• Direct and manage outside counsel and retained experts, driving litigation best practices and guiding defense strategy on active files.
• Mentor Claim Examiners by sharing expertise in investigation techniques, negotiation tactics, and alternative dispute resolution methods.
• Identify emerging exposures and claims trends, communicating findings to leadership and underwriting as needed.
• Recognize and escalate suspected fraudulent claims to the Special Investigations Unit, tracking outcomes and maintaining documentation.
• Maintain accurate, up-to-date claim files – logging all correspondence, investigative notes, and legal documents in accordance with company policies and regulatory requirements.
• Develop training materials and conduct educational sessions for both claims staff and underwriting teams upon request.

Qualifications/Requirements

• Minimum of 8 years of insurance industry experience, with at least 5 years actively involved in professional lines litigation (beyond referral to outside counsel).
• Demonstrated background in Professional Lines claims handling – specifically MPL and related media liability exposures.
• Juris Doctor (JD) from an ABA-accredited law school may substitute for a portion of claims-handling experience, provided litigation involvement is clearly documented.
• Advanced knowledge of claims analysis and adjusting practices, including coverage interpretation, litigation strategy, and negotiation techniques.
• Bachelor’s degree (B.A. or B.S.) from an accredited college or university preferred.
• Strong organizational skills, attention to detail, and ability to prioritize a heavy caseload with minimal supervision.
• Excellent written and verbal communication skills, with the ability to draft legally sound correspondence and liaise effectively with internal and external stakeholders.

Disclaimer: Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer's discretion.

#LI-BC1