Complex Claims & Coverage Director
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Job Description
Complex claims director designing scenarios and evaluating AI outputs for a leading AI lab. Applying senior insurance judgment to coverage disputes, litigation strategy, and major-loss resolution.
Responsibilities:
- Design realistic scenarios involving disputed coverage, reservations of rights, excess exposure, multiple insureds, multiple carriers, allocation, litigation, mediation, bad-faith risk, and high-severity settlement strategy
- Create complex claim strategies, coverage-position analyses, authority requests, litigation-management plans, reserve rationales, and escalation recommendations
- Write “golden” reference responses at senior technical claims quality
- Grade AI-generated responses against structured rubrics for policy analysis, strategic judgment, factual support, stakeholder awareness, and escalation discipline
- Identify claim-handling positions that are internally inconsistent, unsupported by the record, operationally unrealistic, or outside the authority of a non-lawyer claims professional
- Provide written feedback to the research team to improve model behavior
- Participate in onboarding office hours and calibration sessions
Requirements:
- 2+ years of professional experience handling complex, litigated, high-severity, or coverage-sensitive insurance claims
- Experience evaluating coverage issues and developing claim strategies involving multiple parties, layers, policies, or jurisdictions
- Understanding of insurer duties, reservation-of-rights practices, litigation management, settlement authority, and escalation to internal or external counsel
- Ability to distinguish an operational coverage position from formal legal advice and recognize when specialized legal review is required
- Exceptional written reasoning, defensible judgment, and high attention to detail
- Comfort reviewing incomplete records and separating facts, assumptions, open issues, and recommended next steps
- CPCU, AIC, SCLA, ARM, or comparable insurance designation (bonus)
- Experience with excess casualty, professional liability, directors and officers, cyber, environmental, construction-defect, or other complex lines (bonus)
- Experience managing mediations, trials, coverage disputes, or extra-contractual exposure (bonus)
- Home-office technical claims or claim-governance experience (bonus)
- Experience overseeing TPAs, independent adjusters, experts, or panel counsel (bonus)
- This insurance-practitioner role does not require a law degree or license to practice law
Benefits:
- Minimum 20 hours per week (ideally 40+)
- Earn up to $250 for each successful referral
- Reasonable accommodations upon request
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