Senior Complex Claims Specialist

Vela Insurance Services provides specialized Excess and Surplus Lines Casualty and Professional Liability insurance solutions in the following four market segments.: Construction, Specialty Casualty, Velocity Small Business & Professional Liability. We offer national service and local knowledge to our exclusive wholesale broker network and the businesses they serve.

Under limited supervision, the Senior Complex Claim Professional is an individual contributor who investigates, evaluates, negotiates, and resolves the highest complexity litigated and non-litigated claims across multiple lines of business, including General Liability, Products Liability, and Professional Liability. The ideal candidate possesses expert-level coverage knowledge and embraces and advances Best Practices claims handling to industry and company standards, procedures, and objectives.

Welcome working in a team-oriented collaborative environment with other seasoned Claim Professionals

Exhibit expert-level knowledge of the claims process, best practices, and litigation management

Active and affable contributor to the claim process, roundtables, and pre-trial calls to share knowledge and advance skills of others

Analyze and identify coverage issues, prepare coverage letters with expert level coverage knowledge, and collaborate with in-house coverage counsel

Investigate, evaluate, document, and reserve, assessing liability and damages according to Best Practices

Manage litigation by assigning counsel from the approved panel where applicable, establish litigation plan and budget, coordinate with defense counsel, and continuously review for potential resolution.

Establish timely reserves and continuously re-evaluate their adequacy upon receipt of new information

Maintain timely and appropriate file documentation and written file notes

Maintain an active diary and productive file inventory

Timely completion of all required large loss reporting

Negotiate settlements within authority, and attend mediations, mandatory settlement conferences, and/or Alternative Dispute Resolutions

Possess a proactive approach to claim resolution and cost controls

Develop and maintain positive customer relationships and provide superior customer service

Timely identify and pursue all potential opportunities for co-insurance, risk transfer and/or subrogation

Recognize and investigate suspected fraudulent claims

Comply with deductible/self-insured retention and recovery protocols

Meet all State licensing requirements

Adhere to all statutory regulations, Unfair Claims Practices acts, and corporate Best Practices

Serve as mentor and contributor for claims associates; provide technical advice

Assist management with project-oriented work, presentations, and administrative tasks as needed

Other duties as assigned

Four (4) year College Degree, or commensurate experience and training

JD preferred but not required

Industry designations preferred (CRIS, AIC, SCLA, etc.)

Possess and maintain required adjuster licensing in various states

10+ years of complex claims handling experience, including General Liability, Products Liability, and Professional Liability claims

Ability to effectively collaborate with internal and external business partners to advance company objectives and drive favorable outcomes

Excellent oral and written communication skills

Ability to evaluate priorities and meet deadlines efficiently

Possesses advanced expertise in handling complex, high exposure claims in multiple jurisdictions from initial intake through final resolution

In-depth knowledge of the insurance industry, including legal and regulatory environments

Prior experience as a claims manager is a plus but not required

Ability to travel as required

Sponsorship not Offered for this Role