Complex Casualty Claims Specialist

Location: Northern

## Complex Casualty Claims Specialist Apply:
Remote:
Remote in US:
Full time:
Posted Today:
R6566
** At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together.****
* * This position is eligible to work from home anywhere in the US
* *** The Complex Casualty Claims Specialist manages litigation of severely complex claims.  Promptly investigates and evaluates severely complex auto and casualty claims identified as complex per EMC’s claims handling guidelines.  Sets and updates timely, adequate reserves in compliance with the company reserving philosophy and methodology.  Negotiates, settles and/or resolves severely complex claims.  
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* Essential Functions:

** Litigation Management:
* Manages litigation of severely complex claims
* Analyzes lawsuits by reviewing facts and allegations to determine coverage.
* Prepares any Reservation of Rights letters and coverage position letters if warranted
* Prepares lawsuit analysis and formalizes plan to discuss with management
* Collaborates with defense counsel and others to prepare bodily injury and/or damage evaluations, negotiation ranges and target settlement numbers prior to negotiation.
* Obtains higher authority when appropriate
* Negotiates claim settlements with plaintiff’s attorneys
* Completes litigation matters in CLMS and Claims Center claims systems
* Assigns files and collaborates with defense counsel on action plans and litigation strategy to manage litigation expenses and obtain favorable outcomes
* Secures all necessary official reports, claim forms and documents
* Reviews legal budget, invoices, and litigation related expenses for accuracy and appropriateness
* Identifies, investigates, and proactively pursues opportunities for recovery
* Oversees suits, attends trials and mediations and assists with arbitrations, and depositions  Promptly investigates and evaluates claims of severe complexity:
* Reviews the claim notice, contracts, state statutes and policies to verify the appropriate coverage, deductibles, and payees
* Investigates and evaluates complex coverage issues to determine applicable coverage, partnering with EMC Coverage Counsel and/or outside counsel as appropriate
* Initiates timely contact with insureds and claimants to explain the claim process and initiate the investigation
* Obtains statements from insureds, claimants, and witnesses and documents summaries within the claims system
* Requests and analyzes investigative and other relevant reports, claim forms and documents when appropriate
* Documents claim activities, reserve analysis, summaries of reports including Medicare (MSP) modules in the claim system
* Prepares claims and participates in claims round tables to discuss unique cases to evaluate coverage, liability, and damages
* Sets timely, adequate reserves in compliance with the company reserving philosophy and methodology and prepares roundtable reports and large loss reports to advise the Branch VPs and Underwriting Directors
* Identifies, investigates, and proactively pursues opportunities for recovery including partnering with attorneys and/or other experts to arrange of evidence preservation in legal compliance that meets custody, control, transfer, analysis, and disposition of physical and/or electronic evidence
* Adheres to all state requirements regarding regulatory compliance by sending out letters/forms containing appropriate language according to timelines
* Recommends and obtains authority from Supervisor/Director in the assignment of defense counsel
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