Senior Claims Specialist, Auto & Liability

Mitsui Sumitomo Insurance · Chicago · $90,000–$110,000 (stated in the posting)

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MSIG USA continues to grow! 

Company Overview:

MSIG USA is the US-based subsidiary of MS&AD Insurance Group Holdings, Inc., one of the world’s top P&C carriers and a global Class 15 insurer, with A+ ratings and a reach that spans 40+ countries and regions. Leveraging our 350-year heritage, MSIG USA brings the financial strength, expertise, and global footprint to offer commercial insurance solutions that address your business’s unique risks.

Summary / Job Purpose

Responsible for the investigation, evaluation, negotiation and resolution of complex commercial automobile and general liability claims, including bodily injury, property damage, litigated matters and coverage issues. Manages claims proactively from assignment through resolution, establishes sound reserves, develops resolution strategies and delivers timely communication to insureds, brokers and internal stakeholders in accordance with company claim handling guidelines, delegated authority, regulatory requirements and applicable fair claims practices laws.

Essential Functions

Claims Handling and Technical Management - approximately 60%

• Investigates, evaluates and resolves complex commercial auto and general liability claims, including bodily injury, property damage, litigated matters and claims involving coverage or legal issues.
• Develops documented claim strategies addressing liability, damages, causation, coverage, litigation posture and resolution opportunities; updates strategy as material facts change.
• Establishes and maintains accurate reserves based on known facts and anticipated exposure; recommends reserve and settlement values above delegated authority with supporting analysis.
• Manages litigated claims with approved defense counsel, including litigation plans, budgets, discovery, experts, mediation and trial preparation; monitors counsel performance, legal expenses and compliance with litigation management expectations.
• Negotiates fair and timely claim resolutions within delegated authority and participates in mediations, settlement conferences and trials when appropriate.
• Evaluates policy language and coverage issues, recognizes matters requiring escalation or coverage support, and documents the file with timely and well-reasoned analysis.
• Identifies material claim developments and escalates severity, reserve, coverage or litigation concerns to management in a timely manner.
• Pursues subrogation, contribution, contractual risk transfer and other recovery opportunities when supported by the facts and applicable agreements.
• Customer and Stakeholder Service - approximately 20%
• Maintains clear, proactive and professional communication with insureds, brokers, claimants, counsel, underwriting, management and other internal or external stakeholders throughout the claim life cycle.
• Participates in claim reviews, stewardship discussions and account meetings as needed, communicating claim status, exposure, strategy and next steps in a concise business-focused manner.
• Builds collaborative relationships while maintaining appropriate independence, confidentiality and claim-handling discipline.
• Regulatory and Operational Compliance - approximately 20%
• Maintains complete, timely and accurate claim system documentation, including liability and damages evaluations, reserve rationale, litigation strategy, coverage analysis, action plans and material developments.
• Complies with company claim handling guidelines, settlement and reserve authority, fair claims practices requirements, state and federal regulations, licensing and continuing education requirements.
• Ensures required reports, notices and management or Home Office updates are completed accurately and on time; supports audit, quality assurance and governance requirements.
• Uses approved claim systems, data, vendors and expense-management processes; participates in projects, process improvements and other assignments as needed.

Qualifications

Education and Experience

• High school diploma or G.E.D. required; bachelor's degree preferred.
• 7+ years of progressively responsible commercial casualty claim experience, with demonstrated handling of complex automobile and general liability claims.
• Demonstrated experience managing litigated claims, evaluating liability and damages, establishing reserves, negotiating settlements and working with defense counsel.
• Experience with bodily injury, property damage, coverage analysis and contractual risk-transfer issues preferred.
• Knowledge, Skills and Abilities
• Strong knowledge of commercial automobile and general liability claim investigation, liability analysis, damages evaluation, litigation management, reserving and negotiation.
• Ability to interpret insurance policies, endorsements, contracts, pleadings, medical information, expert reports and other legal or technical documents.
• Sound judgment and disciplined decision-making with the ability to identify claim severity and escalate material issues appropriately.
• Strong written and verbal communication skills, including the ability to explain complex claim issues to business partners and senior stakeholders.
• Strong organization, prioritization and file-management skills with the ability to manage multiple complex matters and deadlines.
• Proficiency with Microsoft 365 applications and the ability to learn and effectively use claim management and related systems.
• Credentials and Other Requirements
• AIC, SCLA, CPCU or comparable insurance designation is preferred but not required.
• Maintain all required adjuster licenses and continuing education requirements for assigned jurisdictions.
• Same-day and overnight travel may be required, including attendance at mediations, trials, claim reviews or customer meetings.

It's an exciting time for our company and a great opportunity to join a financially sound and growing global insurance group!  

It is the policy of MSIG USA to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, MSIG USA will provide reasonable accommodations for qualified individuals with disabilities.

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