Senior Claim Specialist

Position Summary

The Casualty Claims Specialist is responsible for managing and resolving highly complex liability claims, including those involving litigation and coverage disputes. This role conducts thorough investigations, evaluates exposure, and negotiates equitable claim resolutions while ensuring compliance with MSMM Claim Handling Guidelines, regulatory requirements, and Fair Claims Practices Acts.

This position plays a critical role in protecting the company’s financial and reputational interests while delivering high-quality service to internal and external stakeholders.

Key Responsibilities

Claims Handling (60%)

• Investigate, evaluate, and manage complex or high-severity casualty claims, including coverage analysis, liability determination, and damages assessment.

• Establish and maintain appropriate case reserves; authorize settlements within designated authority levels and recommend actions for cases exceeding authority.

• Negotiate and execute timely, fair, and equitable claim resolutions in accordance with company guidelines and jurisdictional requirements.

• Manage litigated files, including:

  • Assigning cases to approved defense counsel

  • Providing strategic direction and oversight

  • Monitoring legal performance, budgets, and outcomes

• Attend mediations, settlement conferences, pre-trials, and trials as required.

• Review and approve legal invoices to ensure accuracy and adherence to Litigation Management Program standards.

Customer & Stakeholder Service (20%)

• Deliver responsive, professional claim service to insureds, claimants, brokers, and business partners.

• Maintain proactive communication throughout the life of the claim to ensure transparency and compliance with regulatory expectations.

• Support client-facing activities, including claim reviews, presentations, and partnership meetings with underwriting and distribution teams.

Regulatory Compliance & Operational Excellence (20%)

• Ensure full compliance with state and federal regulations, including Fair Claims Practices Acts.

• Maintain accurate, timely claim documentation and reporting in accordance with MSMM guidelines and statutory requirements.

• Submit required data to regulatory agencies and internal stakeholders.

• Maintain active adjuster licenses and complete continuing education requirements.

• Prepare and deliver regular updates to Home Office and senior stakeholders on claim developments and strategies.

• Participate in special projects, process improvements, and departmental initiatives.

Supervisory Responsibilities

• This role does not have direct supervisory responsibilities.

Qualifications

Education & Experience

• Bachelor’s degree preferred

• Minimum of 7 years of experience handling complex casualty/liability claims, including litigated matters

• Demonstrated expertise in coverage analysis, litigation management, and claim negotiation