What are the responsibilities and job description for the Claims Specialist position at Relm Insurance?
Duties/Responsibilities:
- Manage High-Exposure and Complex Claims:
- Handle claims across Financial Lines (D&O, E&O, Cyber, Crime, Tech Liability) with high financial impact, ensuring efficient resolution while mitigating company exposure.
- Conduct Coverage Analysis:
- Review and interpret policy language, assess coverage applicability, and provide coverage determinations in alignment with legal and regulatory requirements.
- Litigation and Dispute Management:
- Oversee litigation strategies, work closely with external defense counsel, and participate in mediation, arbitration, and settlement negotiations.
- Regulatory and Compliance Oversight:
- Ensure claims handling practices comply with state, federal, and international regulations, particularly in emerging sectors such as blockchain and digital assets.
- Collaborate with Underwriting and Risk Teams:
- Provide insights on claims trends, risk assessments, and policy wording recommendations to enhance underwriting strategies and product development.
- Work with External Partners:
- Liaise with brokers, third-party administrators (TPAs), coverage counsel, and forensic investigators to facilitate claims investigations and resolutions.
- Lead Claims Investigations:
- Conduct in-depth claim assessments, including gathering evidence, interviewing key parties, and analyzing loss data to make well-informed claims decisions.
- Develop and Implement Claims Strategies:
- Establish proactive claims-handling strategies to optimize financial outcomes and improve policyholder experiences.
- Provide Thought Leadership on Emerging Risks:
- Stay ahead of market trends, regulatory developments, and industry best practices, particularly in financial lines and blockchain-related risks.
- Deliver Reports and Stakeholder Communications:
- Prepare detailed claim summaries, risk analyses, and reports for senior management, reinsurers, and regulatory bodies, ensuring transparency and strategic alignment.
- Bachelor’s degree in Law, Business, Finance, Risk Management, or a related field required; Juris Doctor (JD) or advanced degree preferred.
- 3-5 years of experience handling complex financial lines claims, including D&O, E&O, Cyber, Crime, and Technology Liability in an insurance, legal, or risk management setting.
- Strong knowledge of insurance policy language, coverage analysis, and claims resolution strategies, particularly within financial and professional liability lines.
- Experience managing high-exposure, litigated claims, including oversight of outside counsel, mediation, and settlement negotiations.
- Familiarity with regulatory frameworks such as SEC regulations, GDPR, CCPA, AML/KYC compliance, and evolving digital asset insurance requirements.
- Prior experience in blockchain, fintech, or emerging technology-related risks is highly desirable.
- Proven ability to work with third-party administrators (TPAs), brokers, reinsurers, and risk management professionals to drive optimal claims outcomes.
- Strong analytical, negotiation, and communication skills, with the ability to articulate complex coverage issues and claims strategies to internal and external stakeholders.
- Adjuster license in all 50 states strongly preferred; ability to obtain additional state licenses as required.
