Next Insurance

Advocate

• Investigate, evaluate, and resolve General Liability Bodily Injury, Property Damage, as well as Professional Liability claims, both with and without attorney involvement.
• Analyze coverage, liability, and damages based on policy terms, claim reports, statutes, and case law to determine appropriate claim handling.
• Communicate effectively with policyholders, claimants, and witnesses to gather information, provide updates, and guide the claims process.
• Identify and refer potentially fraudulent claims to SIU and pursue third-party subrogation opportunities where applicable.
• Ensure compliance with all relevant statutory and regulatory requirements across jurisdictions.
• Demonstrate strong customer service skills with empathy, clear communication, and a focus on resolution.

Senior Claims Advocate

Manager

• Use your claims-handling expertise to enable great outcomes on complex and litigated claim files through leading independent contributors, direct managers and consulting on high-stakes claim roundtables. Balance multiple roles and responsibilities with leading other Claims Leaders.
• Effectively manage multiple departmental relationships across a highly matrixed organization within a large, international insurance group.
• Partner with critical team members and cross-functional business partners (Product, Legal, Actuarial, Engineering, Information Systems) to effectively utilize and improve existing litigation data and insights.
• Work with internal team members and cross-functional partners in our Data Science group to source litigation data delivery to the Claim’s Org for a variety of use cases.
• Manage vendor portfolio for third-party legal service related vendors. Build effective relationships, drive exceptional outcomes, and deliver against cost goals in this space.
• Work closely with internal Compliance, Legal, and Risk Management teams to enable consistent execution against everything from SOX controls to third-party audit execution on behalf of major capital providers. Complete monthly litigation file audits to help uplevel our collective litigation claim work product through effective evaluation.
• Coordinate critical communication on complex and litigated claims to all key stakeholders, both internal and external.

Senior Litigation Manager

Claims Specialist

• Extensive policy document and legal contract interpretation
• Ability to analyze and identify coverage and related coverage issues
• Leverage a working knowledge of insurance contracts, Unfair Claims Settlement Practices, insurance codes, civil codes, vehicle codes, arbitration rules and regulations, tort law, claims best practices handling and management as part of your ongoing adjudication of claims
• Manage, investigate, and resolve claims within prescribed authority levels
• Recommend ultimate resolution on assigned cases in excess of authority to claims management
• Rely on a deep background of litigation handling experience in both General Liability and Casualty files to resolve claims
• Consistently drive litigation, attend mediations, trials, and other alternative dispute resolution avenues
• Communicate with policyholders, witnesses, and claimants in order to gather information regarding claims, refer tasks to auxiliary resources as necessary, and advise as to the proper course of action
• Preemptively communicate and respond to various written (email, SMS, fax, mail) and telephone inquiries, including status reports
• Present file materials for authority and roundtables
• Work with nurses, doctors, and attorneys on file reviews
• Comply with all statutory and regulatory requirements of all applicable jurisdiction
• Meet detailed quality assurance standards and meet set goals for performance
• Set and revise case reserves in accordance with the reserving policy
• Identify potentially suspicious claims and refer to SIU; identify opportunities for third-party subrogation
• Be accountable for the security of the financial processing of claims, as well as security information contained in claims files
• Work with, and provide claim-specific guidance to, independent field adjusters
• Partner closely with internal teams and advise leadership of key claim activities and exposures

• Handle complex cases involving true Bad Faith claims with adverse and identified coverage/claims handling issues.
• Manage documented cases of daycare abuse/molestation, ensuring thorough investigation and resolution.
• Handle fatality cases with coverage issues, providing expert analysis and resolution.
• Manage construction defect cases, specifically focusing on complex ones involving multiple parties and intricate contractual issues.
• Centralize Declaratory Relief Actions by taking charge of coverage files and coordinating with relevant parties.
• Handle severe injury cases with complex issues, including coverage, liability, or damages concerns.
• Evaluate policy limit exposures, ensuring a true policy limit exposure exists and the potential for extra-contractual exposure is real.
• Address problematic claims that require dedicated attention to achieve resolution.

Senior Claims Advocate

Senior Litigation Manager

Claims Specialist

Claims Litigation Specialist