Senior Complex Claims Consultant / Claims Counsel - EPL/Professional Liability

Department: Claims Administration & Adjusting

Employment Type: Permanent - Full Time

Location: Home United States

Reporting To: Krystal Mutschler

Compensation: $110,000 - $135,000 / year

Description

Our Story

Imagine being part of a team that's not just shaping the future but actively driving it. At Davies North America , we're at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.

Davies North America is looking for a candidate that will be responsible for managing and resolving high-severity, complex insurance claims with a strong emphasis on coverage analysis, policy interpretation, and strategic claim resolution. The position focuses primarily on Employment Practices Liability (EPL) and Professional Liability claims, with additional exposure to Businessowners Policy (BOP) and General Liability (GL) claims within program structures.

The successful candidate will manage a portfolio of complex claims that may involve seven-figure exposures, class or collective action risk, discrimination, harassment, retaliation, wrongful termination, wage and hour allegations, professional negligence, breach of duty, reputational exposure, excess implications, and significant settlement negotiations.

This role requires strong technical claims expertise, sound litigation judgment, coverage analysis capability, and the ability to partner effectively with carriers, insureds, defense counsel, coverage counsel, employment counsel, mediators, and internal stakeholders.

This position is well-suited for either an attorney with employment litigation, insurance coverage, EPL, professional liability, or claims counsel experience, or a senior complex claims professional with demonstrated experience managing high-exposure EPL and professional liability claims.

Key Responsibilities

• Independently manage a portfolio of high-severity EPL and professional liability claims from assignment through resolution.
• Handle matters involving significant financial exposure, including claims with seven-figure reserves, demands, settlements, or potential judgments.
• Evaluate liability, damages, employment law risk, professional negligence allegations, venue risk, reputational exposure, coverage position, and potential excess exposure.
• Analyze pleadings, employment records, personnel documentation, investigation materials, expert reports, wage and hour exposure models, settlement demands, and damages assessments.
• Develop and execute claim resolution strategies based on investigation, legal risk, policy obligations, litigation posture, and business objectives.
• Provide clear, independent evaluations and recommendations to carriers and internal stakeholders.
• Maintain accurate and thorough documentation of claim strategy, liability evaluation, damages analysis, reserves, coverage issues, and resolution activity.

• Oversee complex litigated EPL and professional liability claims, including discrimination, harassment, retaliation, wrongful termination, wage and hour, breach of duty, professional negligence, and other specialty liability matters.
• Direct and partner with defense counsel on litigation strategy, discovery, expert retention, dispositive motions, mediation preparation, and trial planning.
• Review and analyze pleadings, discovery responses, employment records, deposition summaries, expert reports, class or collective action exposure assessments, mediation briefs, and trial evaluations.
• Establish litigation plans, budgets, and key milestones in partnership with counsel and carriers.
• Attend and actively participate in mediations, settlement conferences, strategy meetings, and significant litigation events.
• Provide strategic recommendations regarding settlement, continued defense, alternative dispute resolution, or trial preparation.

• Review and interpret EPL, professional liability, E&O, management liability, excess, umbrella, and specialty liability policies.
• Analyze policy language, endorsements, exclusions, claims-made provisions, notice issues, prior acts, related claims, wage and hour exclusions, punitive damages issues, and allocation concerns.
• Provide recommendations related to defense obligations, indemnity exposure, reservation of rights, coverage defenses, and settlement authority.
• Draft, review, or provide input on reservation of rights letters, coverage position letters, disclaimers, and denial letters, as appropriate.
• Partner with coverage counsel, in-house legal teams, carriers, and internal stakeholders on complex coverage matters.
• Identify and escalate coverage disputes, bad faith concerns, excess exposure, regulatory issues, and other high-risk claim developments.

• Evaluate settlement demands and develop negotiation strategies based on liability, damages, employment law exposure, professional liability exposure, venue, coverage, reputational risk, and potential verdict exposure.
• Negotiate settlements within authority and make recommendations for matters requiring additional approval.
• Manage reserves in accordance with carrier guidelines and claim exposure.
• Participate in mediations and settlement conferences involving high-value EPL and professional liability disputes.
• Balance legal risk, financial exposure, policy obligations, reputational considerations, and business objectives when recommending claim resolution.

Skills, knowledge & expertise

Required (one of the following):

• Juris Doctor (JD) with active bar membership in good standing, or
• 7-10+ years of senior-level experience handling EPL, Professional Liability, GL, or similar complex liability claims.
• Demonstrated experience handling claims with significant financial exposure, including seven-figure settlements, reserves, demands, or potential judgments.
• Strong litigation management experience, including directing outside counsel and developing litigation strategy.
• Experience evaluating liability, damages, coverage, reserves, settlement value, employment law risk, and trial risk.
• Demonstrated expertise in insurance coverage analysis and policy interpretation.
• Experience issuing, drafting, reviewing, or advising on coverage positions, including reservation of rights letters, disclaimers, or denial letters.
• Active adjuster licenses in applicable jurisdictions, or ability to obtain additional licenses as required.
• Strong negotiation, analytical, documentation, and communication skills.

• EPL, employment litigation, professional liability, E&O, management liability, wage and hour, class or collective action, or complex specialty liability claims experience.
• Experience working with employment defense counsel, coverage counsel, mediators, carriers, and insureds.
• Experience working in a Major Case Unit, Complex Claims Unit, Specialty Claims Unit, or Excess Claims environment.
• Prior experience as Claims Counsel, Coverage Counsel, National General Adjuster, Executive General Adjuster, Senior Claims Examiner, Complex Claims Specialist, or Senior Complex Claims Consultant.
• Strong understanding of bad faith risk, excess exposure, allocation, coverage litigation, reputational risk, and complex employment liability evaluation.

Equal Employment Opportunity & Legal Notices

Benefits

At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:

• Medical, dental, and vision plans to support your health and that of your family
• A 401(k) plan with employer matching
• Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees
• Paid holidays
• Life insurance and short-term and long-term disability coverage

Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee's primary work location.

Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.

Diversity and Inclusion

Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.

Compensation Transparency:
The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.

Background Check & Fair Chance Compliance

Any background check or review of criminal history, if applicable to the role, will be conducted only after a conditional offer of employment and in compliance with applicable federal, state, and local laws, including fair-chance hiring requirements.

Massachusetts Notice It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at recruitment@davies-group.com