We're looking for a Senior Claims Technical Specialist to handle high value, complex/severity healthcare-related bodily injury claims (clinical negligence/medical malpractice), across key broker and client accounts in France. The role will be based in our Paris office.
The ideal candidate works within assigned limits of authority requiring a high degree of technical complexity and coordination. May have multiple product line responsibility.
Responsible for the overall management of highly complex Healthcare claims.
Recognised as a technical expert in the interpretation of complex or unusual policy coverages in area of expertise.
Key Responsibilities
- Monitors and predicts claims development trends and plans for consequences and provides market intelligence of competitor activity and initiatives. Keeps current on appropriate regulations and issues, industry activity and trends.
- Understands the way our performance is measured by regulators and brokers and ensures we achieve upper quartile ranking.
- Contributes to business planning and able to articulate and support the UW strategy for respective business unit.
- Makes recommendations on claims processes and resolution strategies to management.
- Partners with solicitors, customers, brokers, experts and insureds to develop a focused strategy for timely and cost-effective resolution of more complex claims.
- Provides guidance and assistance to less experienced claims staff and other functional areas.
- Comply with all applicable legal and regulatory requirements and ensure, at a level appropriate to the position, that appropriate measures are in place to ensure this compliance
- Contributes to organizational profitability by ensuring that claims are effectively managed in accordance with company guidelines and standards. Effectively manages loss costs and claim expenses.
- Builds and maintains collaborative relationships with both internal and external business, such as underwriting, risk control, staff counsel and actuarial partners.
- Makes recommendations on claim policy and procedures and drives claim initiatives.
- Reviews and manages investigations of claims, liability and damages, and works with senior management to determine if major claims should be settled or litigated.
- Manages the negotiation of claims settlement packages including setting reserves and authorizing payment or refers claims to appropriate location for adjudication.
- Remains current on state/territory regulations and issues, industry activity and trends. May participate in industry trade groups.
- Contributes to the development and enhancement of claim training/curriculum.
- Leads project teams and may be accountable for special projects and presentations.
- Comply with all applicable legal and regulatory requirements and ensure, at a level appropriate to the position, that appropriate measures are in place to ensure this compliance.
- May perform additional duties as assigned.
Skills, Knowledge & Experience
- Strong technical claims expertise, ideally with prior operational experience
- Leadership skills with experience mentoring and guiding teams
- Detailed knowledge of the French tribunal/court/justice system – legal background preferred
- Proven experience managing large loss and high-complexity claims
- Oversight of run-off portfolios, triage and allocation of new claims
- Experience with TPA management and technical referrals
- Ability to manage low-complexity claims via TPA oversight
- Strategic relationship management with brokers and clients
- Confident delivering the claims proposition and is able to promote the CNA Hardy brand.
- Participates in key market initiatives
- Advanced technical and product specific expertise, claims resolution skill and knowledge of insurance and claims principles, practices and procedures.
- Strong communication, negotiation and presentation skills. Ability to effectively interact with all levels internal and external business partners.
- Advanced analytical and problem solving skills, with the ability to manage and prioritise multiple projects.
- Ability to deal with ambiguous situations and issues.
- Ability to adapt to change and value diverse opinions and ideas.
- Ability to evaluate claims based on a cost benefit analysis.
- Ability to implement strategies with a proactive long-term view of business goals and objectives.
- Appropriate knowledge of all relevant regulatory and legal requirements applicable to the position
- Ability to drive for superior results in business goals and objectives.
- Creativity in resolving unique and challenging business problems.
The Company
CNA Hardy is a leading specialist commercial insurance provider for clients within the Lloyd’s and company markets. We offer a highly specialised and comprehensive portfolio of innovative and market leading products. Coverage is available to businesses of all sizes for domestic, international and global exposures.
