Claims & SIU Attorney

Looking to join a growing company dedicated to helping others? We offer that, plus competitive salaries, a culture of learning, and a fast-paced environment. This is a hybrid position with 3 days in-office. Join our team to help make a difference in the lives of others! 

Continental General is seeking an experienced Claims & SIU Attorney to support the legal and compliance needs of our growing life insurance and long-term care (LTC) claims operations. This role will focus on handling contested and complex claims, advising on fraud detection and prevention, and supporting Special Investigations Unit (SIU) activities. The ideal candidate will have expertise in claims litigation, regulatory compliance, and fraud-related legal issues, with a strong preference for experience in LTC claims.

Key Responsibilities

Claims Management:

• Provide legal advice and guidance on complex and contested LTC and life insurance coverage disputes.
• Evaluate policy language, coverage, and liability issues to support timely and fair claim resolutions.
• Oversee appeals and disputes involving denied or contested claims.

Fraud Detection and Prevention:

• Collaborate with the SIU team to provide legal support for fraud investigations.
• Advise on legal strategies to detect, prevent, and address fraudulent activities.
• Ensure compliance with applicable fraud-related laws and regulations.

Litigation and Dispute Resolution:

• Manage litigation related to claims disputes, including working closely with external counsel as needed.
• Represent the company in mediations, arbitrations, and other legal proceedings.
• Develop legal strategies to mitigate risk and resolve disputes effectively.

Regulatory Compliance:

• Monitor and interpret changes in state and federal insurance laws affecting claims practices.
• Ensure claims and fraud detection activities comply with all relevant regulations.

Policy Review and Support:

• Assist in drafting and interpreting insurance policies, endorsements, and related documents.
• Provide guidance on policy language to minimize disputes and ensure compliance.

Training and Collaboration:

• Train claims professionals and SIU investigators on regulatory updates, fraud detection best practices, and legal risks.
• Partner with internal teams, including underwriting, compliance, and risk management, to align legal strategies with business goals.

Qualifications

Qualifications

Note: Applicants must be authorized to work for a U.S. employer without sponsorship. We are unable to sponsor or take over sponsorship of an Employment Visa at this time or at any time in the future.

We are considering candidates for either a mid or senior-level position, with the final designation determined based on the candidate's experience and expertise. The salary range for mid-level candidates with 5 years of experience is $120,000 to $150,000, while senior-level candidates with 8 years of experience can expect a range of $150,000 to $180,000.

Education:

• Juris Doctor (JD) degree from an accredited law school.
• Active license to practice law in at least one U.S. jurisdiction.

Experience:

• 5 years of legal experience, with a focus on insurance claims and fraud investigations.
• Demonstrated expertise in contested claims handling, preferably in LTC or life insurance.
• Experience advising on legal issues related to fraud detection and SIU activities.
• Strong knowledge of state and federal insurance regulations.

Skills:

• Analytical and problem-solving skills to navigate complex legal and claims issues.
• Exceptional communication and negotiation abilities.
• Strong collaboration skills to work effectively with cross-functional teams.