Claims Coverage & Practices Counsel - Hybrid or Remote Opportunity

Overview

Claims Coverage & Practices Counsel - Hybrid or Remote Opportunity

Join to apply for the Claims Coverage & Practices Counsel - Hybrid or Remote Opportunity role at The Mutual Group

The Insurance Claims Coverage & Practices Counsel provides strategic legal guidance to Claims leaders and adjusters on coverage decisions, regulatory compliance, and organizational risk. This role focuses on analyzing insurance policy terms, advising on legal and regulatory matters, and supporting the development and refinement of claims processes and documentation. The attorney does not handle litigation or claims directly but plays a critical role in ensuring sound legal practices within the Claims organization.

Responsibilities

• Coverage Analysis and Legal Guidance : Provide timely and practical legal advice to Claims professionals regarding complex coverage determinations across various lines of insurance.
• Interpret and analyze policy language, endorsements, and exclusions to support accurate, consistent, and defensible coverage positions.
• Identify and communicate legal and regulatory risks associated with coverage decisions, ensuring compliance with applicable laws and internal guidelines.
• Collaborate with Claims leaders to develop strategies that align with legal best practices and organizational risk tolerance.
• Offer guidance on emerging legal trends and regulatory developments that may impact coverage interpretations or Claims handling practices.
• Assist in drafting internal coverage position summaries and legal opinions to support Claims decision-making and documentation.
• Claims Communications and Strategic Risk Support : Assist in the drafting, review, and periodic updating of claims notices, reservation of rights letters, and other claims-related communications to ensure clarity, legal accuracy, and regulatory compliance.
• Collaborate with Claims teams to develop standardized templates and guidance for consistent communication practices across the organization.
• Provide legal input on messaging strategies for complex or sensitive claims scenarios, helping to mitigate potential exposure and reputational risk.
• Support strategic decision-making within the Claims department by proactively identifying legal and regulatory risks that may impact operations, coverage positions, or customer communications.
• Participate in cross-functional discussions to align claims practices with evolving legal standards and organizational objectives.
• Process Development, Risk Management, and Legal Monitoring : Contribute to the design, evaluation, and continuous improvement of claims processes and procedures to ensure legal defensibility, operational efficiency, and regulatory compliance.
• Provide legal insight during process reviews and strategic planning sessions to help align Claims operations with evolving legal standards and business objectives.
• Collaborate with internal stakeholders—including Compliance, Risk Management, Legal, and Operations—to identify and address organizational risks that may impact the Claims function.
• Participate in cross-functional initiatives aimed at enhancing claims governance, documentation standards, and risk mitigation strategies.
• Stay current on relevant laws, regulations, and industry trends impacting insurance coverage, and recommend updates to internal policies, training materials, and procedures as needed.
• All other duties as assigned.

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