Claims Specialist

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Company: Relm Insurance

Location: New York, NY 10025

Description:

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.

Requirements
  • 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.

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