Insurance Lawyer In-House

Our client, a global insurance firm, is seeking a Qualified Insurance Lawyer for a new Senior Claims Examiner opening within their London Market Casualty Claims Team on a full-time basis. This role, based in their London office on a hybrid-basis, encompasses the examination, analysis, negotiation, and settlement of claims from cradle to grave, including the review of claims data and underwriting documentation to establish the validity of losses notified.

In addition to handling claims, the successful candidate will liaise internationally on issues related to Casualty claims. They will play an active role in negotiating settlements, participating in market meetings, and authorizing claims, necessitating a strong understanding of London market processes. Compliance with internally set Key Performance Indicators and regulatory requirements is also essential.

• Examine claim data and underwriting documentation to ascertain validity of losses notified against cover provided and establish premium payment status.
• Establish adequate reserves and make reserving judgements of potential anticipated losses in a timely and professional manner to meet levels of service expected by internal and external customers.
• Recognition of contentious issues and, where appropriate, inform claims management to discuss legal obligations and/or remedies and take appropriate action, therefore ensuring that only valid claims are paid.
• Be experienced and confident in the management of complex coverage issues and policy declinatures.
• Undertake claim handling obligations responsibly, thereby preserving and protecting Sompo International’s image as a respected leading underwriting entity.
• Comfortably handle complex open-market and delegated claims valued in excess of USD1,000,000 in multiple jurisdictions including most/all of SI’s current key territories.
• Assist with claim reviews and audits at the offices of Coverholders, ceding companies, TPAs and other Insurers and to report on their compliance or otherwise with terms and conditions of risks written and their overall claims handling service.
• Assist with loss fund setup and management.
• Assist with onboarding and setup of key delegated claims arrangements.
• Establish adequate reserves in a timely fashion for the estimated amounts of anticipated loss and/or adjustment and coverage expenses. Ensure accurate recording of reserves on the business' claims systems. Conduct regular reviews of the claim portfolio to assess the adequacy of reserves being carried. Demonstrate a comprehensive understanding of watchlist processes and recording of reserve volatility.
• Demonstrate full control and oversight of all stakeholders in the claims process, including lawyers, loss adjusters, technical and medical experts. Be prepared to challenge advice and review evidence / recommendations critically.
• Negotiate economic settlements and authorise claim payments in a professional and timely manner to meet the levels of service expected by the market, customers and other stakeholders.
• Recognise contentious issues and, where appropriate, inform claims management to discuss legal obligations and/or remedies and take appropriate action.
• Inform claims management for onward reporting of any large or unusual losses in order that financial exposure can be fully evaluated, and future corrective measures can be determined. This includes the drafting of Large Loss Notices in a timely manner for distribution around the business and the maintaining and updating of the company Claims Watchlist.
• Manage and monitor the performance of outsourced Coverholders and TPAs where appropriate to ensure that customers receive a good level of service from both our external and internal claims handlers. Conduct internal audits of TPAs to ensure technical compliance. Review and process complex claims referrals with speed and authority from TPA’s. Detect, and intervene when poor claims handling and strategy is noted.
• Ensure ongoing financial accuracy of outsourced claims reporting and validation of financials on Sompo claims systems. Effective understanding and management of claims bordereaux. Able to analyse and understand bordereaux financials and movements.
• Maintain accurate and presentable claims files, which contain all necessary documentary evidence, communications, and files notes. Files will demonstrate ownership of claims strategy and reserve.
• Experienced in the use of a range of London market claims systems.
• Attend internal claim meetings, market meetings and seminars and to represent the company as and when required. When required, support management by preparing and supervising internal and external meetings, including team meetings and meetings with underwriters / brokers / policyholders.
• To ensure that appropriate ‘soft skills’ are utilised in order to communicate with people internally and externally in an effective and professional manner, to actively encourage teamwork within both the claims department and the business as a whole and to aid in successful conflict resolution.
• Provide ongoing mentoring and technical guidance to junior members of the team.

Required Skills & Experience

• Experience in third party claims.
• Be technically proficient and have a proven record of successfully handling primary and excess lead / follow Casualty claims (i.e. EL/PL/Property Liability and Product Liability) in multiple jurisdictions and valued in excess of USD1,000,000
• Have a proven track record of handling referrals of such claims from TPAs/Coverholders.
• Have a good understanding of the insurance industry, particularly the London and Lloyd’s insurance markets and their claims systems (e.g. ECF2, the IMR and Writeback)
• Be an effective and efficient communicator both orally and in writing.
• Be willing to support / mentor junior members of the team and advance / enhance their technical skills.
• Deputise for the Casualty claims manager in meetings and during holiday absences.
• Participate in team discussions and help foster a collaborative team approach.
• Support managers, senior members of the company in advancing business wide goals.
• IT/PC skills to include Word, Excel and Powerpoint.
• Adhere to existing procedures and think of creative and efficient ways of streamlining processes and procedures.

• Handling claims on multiple lines of Casualty business (EL/PL/Product Liability/Property Liability).
• Have experience of handling such claims in multiple jurisdictions, including Australia, Canada, Ireland, UK and USA.
• Have a solid understanding and experience of excess casualty claims handling.
• Knowledge of reinsurance arrangements.

As stated, this role is hybrid requiring approx. 3 days a week in the offices, which are location near Tower Bridge / Fenchurch Street.

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