Claims Coverage Counsel/Claims Coverage Administrator

Merchants Insurance Group; Buffalo (NY); Hybrid; USD 100,000 - 145,000; Full time

Benefits offered by this job

Hybrid work schedule

Flexible work arrangements

Tuition Reimbursement

401(k) match program

Generous paid time off

Job summary

Merchants Insurance Group in Buffalo, NY is seeking an experienced Claims Coverage Counsel or Claims Coverage Administrator for our Corporate Claim Legal Team.

The role focuses on complex coverage analysis, drafting opinions, coordinating with outside counsel, and providing support to underwriting and regulatory programs while training staff.

Hybrid work is offered; two days in the office weekly are required with flexibility for remote work on other days.

Qualifications

• JD preferred, licensed in good standing.
• 5+ years in insurance coverage analysis or litigation.
• Strong legal research and writing skills.
• Experience with construction/labor law coverage issues.
• Ability to train claims staff and interact with management.

Responsibilities

• Prepares coverage communication consistent with internal quality standards and applicable state regulations.
• Works collaboratively with front-line claims professionals and managers to provide coverage analysis and preparation or review of coverage position letters for claims involving complex coverage issues or disputes.
• Provides legal or coverage guidance to claim professionals handling declaratory judgment actions in which Merchants is a named party.
• Directs outside counsel on litigation strategy.
• Leads claim staff in training involving legal or coverage matters.
• Provides claim legal support to underwriting and product development teams. Also assists in regulatory compliance programs by providing supplementary research regarding statutes and regulations impacting our business.

Skills

Insurance coverage analysis

Legal research

Risk assessment

Leadership

Written communication

Regulatory compliance

Construction & labor law

Training/mentoring

Education

Juris Doctor (JD)

Tools

Westlaw

Job description

Claims Coverage Counsel/Claims Coverage Administrator

Job Category: Claims

Requisition Number: CLAIM001725

• Full-Time
• Hybrid

Locations

Showing 1 location

Description

Claims Coverage Counsel/Claims Coverage Administrator

Hybrid Work Schedule

Merchants Insurance Group is a leading Property and Casualty Insurer in the Northeast and is looking for an experienced Claims Coverage Counsel or Claims Coverage Administrator for our Corporate Claim Legal Team located in Buffalo, NY.

We are seeking individuals with previous experience in insurance coverage analysis/determination/disposition for at least five years. While a law degree is preferred, we are also considering individuals without a law degree that have deep technical experience in significant and complex coverage scenarios to include New York construction/labor law and other commercial claims.

This position will be responsible for preparing coverage opinions and coverage position letters for claims involving complex coverage issues or disputes. This role will also assist claims professionals in the evaluation of risk transfer opportunities, priority of coverage, and tender strategies. Coverage Counsel/Coverage Administrator is responsible for assessing and directing coverage litigation strategy in conjunction with outside counsel and the claims professional, including developing and executing a plan to manage the coverage litigation through final resolution. This individual may also provide legal support to underwriting, product development and regulatory compliance programs (JD candidate only).

This position is responsible for both first- and third-party coverage review, analysis and decisions for all levels of claims, including those involved in litigation. In addition, the individual will provide claim, policy, regulatory and legal expertise, if or as appropriate, to all levels of management up to and including senior management. The role will also review all policy forms for updates and revisions, ensuring compliance with state regulations, as well as applicable statutes and case law. The position will also require training for all levels of claims staff in matters of policy interpretation, investigatory processes, regulatory compliance and good faith claims practices across multiple venues.

Merchants Insurance Group is rated A- (Excellent) with a stable outlook by A.M. Best and is consistently recognized as a top employer and high-performing organization. Recent honors include:

• Best Places to Work in Western New York (Buffalo Business First, 2023-2026)
• Fast Track Company (2019-2025) and Top Private Company (2019-2025)
• Ward's 50 top-performing property-casualty insurer (2021-2024)
• Ivans Spark Award for Innovation (2024-2025)
• Named to Newsweek and Statista's America's Most Reliable Companies list (2025), ranked among the top 300 of 1,500 B2B organizations evaluated

We offer a hybrid work schedule, requiring two full days per week in the office, with flexibility to work remotely or in office the remaining days. This model supports collaboration while providing flexibility and work-life balance.

Essential Duties and Responsibilities include, but are not limited to:

• Prepares coverage communication consistent with internal quality standards and applicable state regulations.
• Works collaboratively with front-line claims professionals and managers to provide coverage analysis and preparation or review of coverage position letters for claims involving complex coverage issues or disputes.
• Provides legal or coverage guidance to claim professionals handling declaratory judgment actions in which Merchants is a named party.
• Directs outside counsel on litigation strategy.
• Leads claim staff in training involving legal or coverage matters.
• Provides claim legal support to underwriting and product development teams. Also assists in regulatory compliance programs by providing supplementary research regarding statutes and regulations impacting our business.

Qualifications & Skills:

• Juris Doctor degree preferred, with license in good standing
• Minimum 5 years of insurance coverage experience and/or practicing attorney experience
• Proficiency with Westlaw or other legal research applications CPCU highly desirable
• Minimum 10 years of technical experience in complex coverage analysis
• Prior leadership experience is highly desired
• High degree of competency in insurance coverage analysis, policy construction, and legal research with exemplary writing skills.
• Ability to transfer knowledge through formal and informal training with demonstrated excellent written and oral presentation skills.
• Advanced written and oral communication skills with influence, initiative, and ability to communicate effectively across all levels across an insurance organization to include cross-departmental relationships.
• Experience with construction and labor law litigation coverage issues related to risk transfer.
• Proven demonstration of creative problem-solving abilities.
• Excellent interpersonal skills with the ability to lead and work in a cooperative manner.

Merchants Insurance Group Pay information:

Merchants Insurance Group offers a competitive pay scale. The estimated salary for this role ranges from $100,000 - $145,000 based on leveling and geography, along with an equity component and a comprehensive benefits package. This range is merely an estimate; actual compensation may deviate from this range based on skills, experience and qualifications.

Merchants Insurance Group Benefits:

• Welcoming and positive work environment.
• Colleague Appreciation Events.
• Flexible work arrangements, including flex scheduling and summer hours.
• Hybrid work schedule. The Hybrid work schedule will require 2 full days per week in the office, with the option of working the remaining days per month at home or in the office.
• Competitive pay scale.
• Generous paid time off package.
• Full Benefits: Health, Dental, Vision, Life Insurance, Short Term Disability, 401(k) employer match amount is 100% up to 6% of your annual contributions. You are immediately 100% vested in the employer match dollars.
• Outstanding company bonus program.
• Tuition Reimbursement.

And many more exciting company benefits!!

Merchants Insurance Group is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status. Merchants Insurance Group supports a safe workplace through pre-employment background screenings.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.