If you’re passionate about helping people protect what matters most to them, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide’s Property and Casualty team could be the place for you!
- Prior experience handling environmental/asbestos claims preferred
- This is a work from home position, and can be filled in any location.
- Compensation grade (Internal Use Only): G3
Job Description Summary
Our team handles some of the most unique and interesting insurance claims at Nationwide. Do you have deep insurance industry knowledge, good negotiation skills and understand litigation? If you like variety and complexity in your work, have desire to collaborate and bring equitable resolution to reinsurance claims, we want to hear from you!
As a Consultant, you'll independently handle assigned complex and/or high exposure reinsurance claims arising out of company-assumed contracts requiring investigation, liability evaluation and negotiation. In addition, you'll conduct or participate in claim audits of ceding companies and communicate regularly with company management on status of assigned claims. We'll count on you to promote and provide outstanding service to customers. Reinsurance claims caseload will include in asbestos, toxic tort, pollution, E&O and/or D&O claims.
Approves company-assumed policy payments or partial payments when appropriate. Communicates positions (payments or denials) to brokers, ceding companies or other parties at interest.
Reviews claims for accuracy, ensuring all processing and preliminary work has been completed by claims processors. Evaluates claim information provided by ceding companies and brokers. Applies and interprets coverage and reviews any investigation material supplied to assure that key issues have been properly addressed. Requests additional information as needed.
Monitors claims to closure. Performs continuous review of assigned claims inventory. Follows the investigation of the reinsured and suggests additional areas or means of investigation, if indicated. Acquires necessary information and documentation to support ceding company settlement decisions and payments.
Handles or directs the handling for insolvent or financially distressed companies. Identifies treaty involvement, both assumed and ceded. Advises appropriate personnel in Legal and Finance.
Identifies claims that have the potential for retrocessional reinsurance recovery pursuant to company protective covers. Coordinates activities with reinsurance collection personnel as appropriate.
Evaluates ceding companies' decisions on liability, settlement values, compensation, and/or medical payments.
Provides reserve analysis to ensure timely and accurate case reserves.
Negotiates resolution of disputed positions with ceding companies where required. Assists in the drafting of settlement documents.
Maintains current knowledge of assigned insurance lines; court decisions which may impact the claim function; current guidelines; and policy changes and modifications. This may require attendance at various seminars or training session
Assists the Claims Manager train, direct and guide other unit employees. Answers inquiries on specific files as to coverage or payment issues and/or investigative areas. Reviews the work of individuals as directed.
Serves as company representative or fact witness at deposition and/or mediation, litigation/arbitration proceedings arising from coverage determinations. Manages litigation where appropriate.
Creates and analyzes severe incident reports, reinsurance reports and other information to corporate office, Claims Management and Underwriting.
Functions as a key product delivery participant and interacts with other company functions to serve broad company interests. Maintains effective broker, producer, and other professional relationships. Furnishes relevant reports, memorandum and analysis to management as necessary. Participates on assigned projects and committees. Contributes to work productivity and expense control. Efficiently organizes and processes delegated work. Uses the most efficient means of achieving quality case handling results.
Oversees defense counsel in all lawsuit activities from inception throughout the life of the claim.
Provides advice, counsel, and training to Claims Representatives of all levels. Provides specialized training and consultation to non-claims areas as requested.
May perform other responsibilities as assigned.
Reporting Relationships: Reports to Claims Director or AVP.
Typical Skills and Experiences:
Education: Undergraduate degree in related field preferred. Post-graduate studies (MBA, JD) desired.
License/Certification/Designation: State licensing where required. Relevant professional designations or certifications desirable (CPCU, ARe, etc.).
Experience: Eight to 10 years of progressive primary, excess or reinsurance commercial casualty claims experience in the area of asbestos, toxic tort or pollution preferred.
Knowledge, Abilities and Skills: Proven in-depth knowledge of reinsurance contracts ceded claims processes, and legal aspects of reinsurance claims. Proven ability to meet customer needs and provide outstanding service by informing customers of the claims process and ensuring a positive customer experience. Demonstrated analytical skills to make independent decisions and resolve conflict in such areas as application of coverage to submitted claims, application of laws, of jurisdiction to investigation facts, application of treaty exclusions and exceptions. Ability to function with minimum supervision and possess the ability to effectively manage conflict. Advanced verbal and written communication skills for interaction with ceding companies, brokers, counsel and other internal and external customers.
Other criteria, including leadership skills, proficiencies and experiences may take precedence.
Staffing exceptions to the above must be approved by the business unit executive and Human Resources.
Values: Regularly and consistently demonstrates Nationwide Values.
Overtime Eligibility: Not Eligible (Exempt)
Working Conditions: Normal office environment. Must be able participate in on-site audits of ceding companies, for the purpose of inspecting their files and records. Ability to travel with overnight stays required.
ADA: The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.
Credit/Background Check: Due to the fiduciary accountabilities within this job, a valid credit and/or background check will be required as part of the selection process.#claims