Senior Claims Manager, Cyber

About TMHCC
Tokio Marine HCC (TMHCC) brings 50 years of service to the specialty insurance industry today offering over 100 products to commercial customers in 180 countries around the world. Every policy we write is special enabling our clients to do amazing things. From insuring the crops that feed us to the rock concerts that entertain us to rescuing international travelers in trouble.
Organic growth and over 60 successful acquisitions have grown our 2023 Gross Written Premium (GWP) to over $7.5 Billion. Our workforce has grown to 4300 worldwide big but not so big that you cannot make a difference. Our Good Company values including integrity empowerment and commitment to customer service and a culture of innovation communication and collaboration make TMHCC a great place to work.
What We Offer

• Competitive salary and employee benefit package
• Strong learning culture
• Growth perspectives
• 6% 401K match
• 20 days of PTO and 2 Floating Days
• Paid parental leave
• An opportunity to love what you do

Job Summary

Leads and directs a team of claims professionals handling Reinsurance and Open Market cyber media and technology error and omissions claims and litigation. Manages claims as well as claims staff in other areas including Miscellaneous Professional Liability Employment Practices Liability and other specialty liability insurance products. Ensures the claims staff is following company procedures and that benefits are paid to those who are eligible. Analyzes and reviews legal pleadings documents and applicable statutes to determine validity of liability claims.

Key Responsibilities

Relying on advanced knowledge and strong leadership skills this role is accountable for the following responsibilities:

Supervise and direct a team of claims professionals handling primarily Cyber Media and Technology Errors & Omissions claims and manage team workflow.

Coordinate work activities of the team.

Responsible for development and coaching of staff to maximize proper handling.

Build a teamoriented environment by establishing team and individual goals through empowerment.

Coach and mentor direct reports and provide training opportunities.

Educate and train team members in the duties and responsibilities of best claims practices.

Review and evaluate the performance of personnel and define goals.

Perform quality reviews on claims in compliance with internal and external audit requirements.

Communicate with internal and external stakeholders including insureds brokers/agents and insurance carrier clients and provide exceptional customer service.

Provide in depth coverage analysis and wording interpretation.

Conduct investigations and evaluate liability to determine validity of complex claims.

Provide oversight to direct reports with regard to formulation and issuance of coverage position letters negotiation and resolution of claims and decisionmaking within defined authority through delegation and empowerment.

Prepare and draft complex legal correspondence to affected parties. Maintain electronic claim files. Update files as needed.

Oversee all aspects of the litigation process for highexposure liability claims to minimize company risk of loss.

Negotiate claim settlements within defined authority limit.

Recommend and present proposed claim resolution and/or settlement terms to management for claims that are in excess of the defined authority limit.

Develop and maintain processes and procedures for the team in coordination with Claims Department Management.

Recommend and implement techniques to improve productivity and efficiency and cut costs.

Oversee outside counsel and vendors related to claims handling responsibilities.

Keep current on state regulations with issues industry activities and trends. Attend settlement conferences mediations and facilitation hearings on the Companys behalf as needed.

Provide supervision and guidance to less experienced Claims personnel including the review of settlement payments and denials but obtain appropriate authority to issue denials.

Provide timely and accurate reporting to management and other internal clients including summaries of open/closed claims or other related bordereaux. Support Claims Department Management and Underwriting unit as needed.

Obtain and maintain claims adjusters licenses or other professional designations as required by the Company.

Oversee the payment of claims on the basis of the coverage of the insurance customer the proof of damage and an insurance appraisal.

Ensure that all claims are valid according to the company policy and consult with legal representation when necessary.

Review and respond to claim referrals and questions from claims staff.

Review and respond to claim appeals and grievances.

Perform claims reviews and makes recommendations based on policy provisions and processing guidelines.

Prepare and present reports on claims performance trends and operational efficiencies to senior management.

Competencies

Planning

Develop and implement shortterm and longterm plans to improve business processes for department.

Coordinate resources to ensure strategies are executed

Communication

Communicate team or group plans or results at all organizational levels. Prepare written and verbal presentations that educate and inform on area of responsibility/expertise.

Write or is a major contributor to management/technical reports or contractual documents

Cost Management

Lead business process improvement for the department.

Develop and is accountable for budget of the department.

Perform cost benefit analyses for the department.

Business Controls and Policies

Comply with all corporate policies and procedures.

Identify control objectives for designated function and implement cost effective controls designed to meet those objectives.

Test controls to determine if they are performing as intended

People Management

Has full HR responsibility for direct reports including making hiring decisions training coordinating work establishing standards reviewing work conducting performance appraisals and providing coaching or counseling.