Claim Litigation Manager

  • Church Mutual Insurance Company
  • Madison, WI, USA
Full time Insurance

Job Description

Manage and provide operational and technical oversight to the Complex Litigation unit in accordance with company claim policies, practices, and procedures within delegated authority levels. Ensure Technical Claim Specialists are conducting thorough investigations, completing proper exposure analysis, establishing timely reserves, and developing and implementing resolution strategies, and partnering with all stakeholders for the best total claim outcome. Ensure that Technical Claim Specialists are properly preparing their files for resolution, hearing, trial, or other settlement forums. Managerial responsibilities include staffing, training and development, performance management and workforce planning.
Responsibilities
• Manager responsibilities may include all of the following:
o Staffing needs, to include interviewing and onboarding for new employees.
o Training and development, as well as coaching and motivation for staff.
o Performance management, goal setting, employee engagement, and salary administration.
o Workforce Management to include: unit equipment, software, and space needs, approving time off and overtime usage, and budget recommendations.
• Provide file handling guidance, direction, and resolution strategy on complex cases that exceed claim handler authority in full alignment with achieving outcome accuracy, adherence to jurisdictional compliance requirements, and support of all department best practices execution.
• Provide mentoring and training to casualty claims staff, to include, but not limited to, enhanced litigation management practices, risk transfer, EPL/DOT, professional liability, and construction defect.
• Ensure all cases that will be tried, go to a state hearing process, or other form of settlement or dispute resolution, are properly selected and prepared prior to the initiation of this process. This includes following best practices, ensuring cases are properly reserved, and all communication protocols have been followed.
• Provide internal claims coverage analysis as to all CM Group policy forms including CM Group subsidiaries. Consult on complex referrals with Claims-Legal and determine when outside opinions are warranted.
• Review and approve complex coverage denials and reservation of rights letters.
• Consult on compensability decisions and provides technical input and strategic recommendations during case reserving, settlement authority and pretrial roundtables/conferences, with follow-up communications to senior management as appropriate.
• Ensure proper execution and utilization of all applicable loss mitigation, cost containment, and litigation management strategies.
• Conduct technical file reviews of the department's most complex cases, aged pending cases, or other files as requested. Partner closely with claims audit staff to ensure alignment and consistent execution of best practices.
• Oversee the timely settlement of claims and acceptable closing ratios for the line of business.
• Ensure each unit is meeting the expectations as defined through the unit's best practice guidelines and in compliance with all applicable legal and regulatory requirements.
• Provide oversight on expense control in accordance with the unit's policies, practices, and procedures.
• Manage and keep current on all claims processes, procedures, and changes in accordance with company guidelines.
• Maintain override capability, authorize settlements up to designated authority limits, and submit recommendations to designated officials for those claims in excess of authority level.
 
Qualifications
• Bachelor's degree is required. A Juris Doctorate degree from an accredited law school is preferred, but is not necessary if the candidate has significant experience in handling and/or overseeing litigation, including complex and high exposure casualty claims.
• Completion of CPCU, AIM, and/or SCLA designations is preferred.
• Minimum of eight years commercial lines claims experience including prior supervisory experience in a casualty claims handling environment is required, including handling, and overseeing complex/high exposure casualty claims and litigation.
• Strong knowledge of multijurisdictional legal principles.
• Experience working with and executing loss mitigations, cost containment strategies, and resources.
• Excellent technical and product specific expertise, claims resolution skill, and knowledge of insurance and claims principles, practices, and procedures.
• Excellent verbal and written communication and presentation skills. Excellent negotiation, consultative, and facilitation skills.
• Proven ability to effectively partner, collaborate, and communicate with all internal and external business partners.
• Strong customer service focus.
• Evident of ability to understand and utilize business reports and other data analysis tools.
• Strong team building skills
• Proven ability to take a proactive long-term view of business goals and objectives to achieve strategic business results.
 
The CM Group is made up of Church Mutual Insurance Company, S.I., CM Regent Insurance Company, CM Vantage Specialty Insurance Company and CM Select Insurance Company.
 
Church Mutual is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.