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Melinda Burrows
Deputy General Counsel
- Litigation and
Compliance, Progress
Energy Service Company
LLC
 

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Claims Coverage Litigation Counsel
Refer job# PSIB159056
 
Claims Coverage Litigation Counsel Duties: Adjudicate the company's most complex and challenging claims with a concentration in coverage and declaratory judgment action. Provide coverage guidance and analysis to Complex Claims Coverage Specialists across the organization as well as investigation, evaluation, negotiation and disposition of assigned claims and acts as a subject matter expert. Provides expertise in contract policy language to Complex Claims Specialists across the organization. Responsible for file guidance on insured status and contractual indemnification. Evaluates and resolves coverage issues for all lines of business. As requested, provides guidance relative to all aspects of coverage matters on the application and legality of policy provisions and policy language. Provides guidance on issues involving additional insured status and contractual indemnification. Thoroughly investigates claims through communication with claimants, attorneys, insured, witnesses and other having pertinent information. Analyzes information in order to evaluate assigned claims to determine the extent of loss, taking into consideration contributory or comparative negligence. Assigns medical or other experts to case and arranges for medical examinations when necessary. Effectively evaluates, negotiates and resolves claims within delegated authority utilizing the appropriate denials or releases. Manages vendors and expenses. Provides required reports to colleagues in Claims, Corporate Legal, Underwriting, Reinsurance and Actuarial on significant exposure cases. Provides reports to senior management on extra contractual liability claims. Reports on all cases going to trial on a timely basis. Attends portions of trials when warranted or upon management request. Determines when to reserve rights or decline coverage. Drafts coverage position letters and the propriety of filing declaratory judgment actions.

Qualifications: College degree preferred. Multi-State licensing. Law degree preferred. 8+ years of claim experience in the Property & Casualty Industry. Of those, 5+ years handling coverage claims of a complex nature with a primary P&C carrier.. Experience in complex coverage analysis and significant large loss evaluations. Superior claim disposition skills. Strong understanding of Medicare reporting and compliance. Ability to handle or oversee Extra-Contractual, EPLI, Social Services and E&O claims against the company. Strong technical knowledge of occurrence and claims made coverage forms. Superior communication and strategic negotiation skills. Proven problem-solving skills. Excellent presentation skills.
 
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