Associate Claims Coverage Counsel

Responsible for the management of coverage matters arising on all reported claims including but not limited to Liability, Property, Ocean Marine, Management Liability and Foreign Package Liability matters.  Duties include both the handling and supervision of coverage matters including the ultimate determination of the applicability or non-applicability of coverage under insurance policies issued by Mitsui Sumitomo.  Assist adjusters in the development of coverage positions and the preparation of coverage position letters.

Maintain detailed records regarding all questions of coverage applicability and referral or non-referral of coverage matters to outside coverage counsel.  Develop and maintain coverage manuals and assist in the development of policy forms and endorsements.

1) Receive referrals of all new coverage issues (questions) identified by Claim Adjusters, Managers and Lead Coverage Counsel.

2) Review with adjusters the issues/questions of coverage to be determined and the necessary coverage investigation to support those determinations.  Determine if matter is to be handled internally, or be referred to outside counsel, identify the referral firm (from the approved list) and make the appropriate referral.  Document referral and associated issues. 

3) Ensure that the appropriate general reservation of rights letter is prepared and communicated to the insured.

4) Prepare coverage opinions for submission to Claim Manager or Lead Coverage Counsel memorializing the coverage issues involved, the appropriate law governing such issues, and the recommended coverage position.  Appropriate time frames for completion of investigation and coverage determination will be established and communicated to all parties (claim adjusters, managers, and lead coverage counsel).

5) Maintain a timely diary of all coverage matters, to ensure timely handling by claim adjusters and coverage counsel.

6) Review coverage opinions of outside coverage counsel to ensure all questions have been answered or resolved and appropriate coverage position is taken.

7) On recommended declinations, ensure timely resolution of recommendations and ensure that the Claim Manager and CCO have received the recommended action to be taken.

8) Retain selected coverage matters for oversight and handling as coverage counsel.  Number and type of matters retained will depend on issues and volume.