SVP, Head of Coverage & Complex Claims

The Head of Coverage and Complex Claims will lead all Complex Claims operations providing strategic oversight and executive leadership across all complex and long-term exposure claims. This position reports to the Head of North America Claims and is responsible for directing high-stakes litigation strategies ensuring effective claims resolution managing long-tail exposure claims and advising on legal and coverage-related and regulatory risks.

The successful candidate will possess extensive experience and technical expertise in complex and coverage litigation with a proven record of developing and managing highly engaged high-performance teams. This person will be a change agent with exceptional leadership skills capable of driving efficiencies as a result of a deep understanding of complex claims environments. This role requires a strong executive presence exceptional leadership skills and the ability to foster collaborative relationships within the organization. A law degree is required to navigate the intricate legal and regulatory landscape of complex claims.

Key Responsibilities

Strategic Leadership:

• Exhibit a strong executive presence and communicate effectively with senior leadership on significant complex claims issues and trends. Effectively present difficult claim matters at a high level to a senior audience.
• Identify and elevate potential issues before they arise and take proactive steps to develop strategic solutions. Drive successful outcomes and mentor train and develop the claims teams to adopt the same mindset and priorities.
• Lead mentor and inspire a high-performing team of claims professionals fostering a collaborative environment and supporting continuous professional development.

Operational Excellence:

• Oversee and manage complex claims operations ensuring efficient and effective resolution strategies and compliance with company standards.
• Innovate service improvements that balance efficiency/productivity defense and indemnity management customer service and quality assurance controls.
• Develop and deliver an effective operating model focusing on key strategic priorities and performance improvement initiatives. Leverage claim and data systems (in partnership with Finance Actuary Data Analytics) to improve claim processes drive operational efficiencies and produce results. Use data-driven insights to improve claims processes and present regular performance and risk analysis reports to senior audience.
• Manage audit process that integrates meaningful quality standards validates appropriate controls and provides value to leadership team.
• Litigation Strategy:Develop and lead litigation strategies for high-exposure claims minimizing financial risk and defending company interests in collaboration with internal and external legal teams.
• Long-Term Exposure and Mass Tort Claims:Provide executive oversight of long-tail exposure and mass tort claims ensuring comprehensive analysis and risk assessment.
• Policy and Compliance:Ensure all operations are in full compliance with legal regulatory and corporate policies while proactively addressing emerging risks.
• Stakeholder Collaboration:Collaborate with other departments including legal underwriting actuarial and compliance to manage claims and align strategies with broader company goals.
• Risk Management:Identify assess and mitigate legal and financial risks associated with complex claims developing proactive strategies for risk reduction.
• Data Analysis and Reporting:Leverage data-driven insights to improve claims processes monitor performance and present regular performance and risk analysis reports to senior leadership.
• Innovation and Process Improvement:Drive innovation in claims handling processes leveraging technology and best practices to enhance efficiency customer experience and outcomes.

• Education:Juris Doctor (JD) degree from an accredited law school; active bar membership preferred.
• Experience:Minimum of 15 years in complex claims and litigation management within the insurance industry with a proven track record of leading complex teams and managing high-stakes long-term exposure and mass tort claims.
• Business Experience: Strong business acumen particularly in managing expenses loss budgets and implementing long term planning goals. Able to analyze complex business challenges and apply analytics to drive strategic solutions. Proficient in using data analysis to inform decision-making and optimize claims processes.
• Leadership Skills:Demonstrated executive leadership in the insurance industry with specific experience in leading motivating and managing large teams in a high-stakes environment. Proven track record engaging employees within a claims organization.
• Communication Skills: Exceptional written and verbal communication skills with the ability to present complex information clearly and effectively to a senior level audience.
• Technical Expertise: Deep technical and subject matter experience across a diversified long tail insurance portfolio including understanding complex insurance coverage issues engaging in comprehensive analysis and risk assessment and identifying existing and emerging claim trends.
• Strategic Thinking:Ability to develop and implement forward-thinking strategies that align with corporate objectives and regulatory requirements.
• Risk and Compliance Knowledge:Strong understanding of regulatory legal and compliance issues affecting the insurance industry.