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Years of Experience
Date Last Verified
ProfileSenior Counsel The candidate will provide legal support for the various life and health insurance operations units, including claims, underwriting and policyholder services, by researching and analyzing issues/ laws, drafting legal opinions and counseling business partners on application of complex regulatory requirements to the business' practices. Will gather and analyze facts and apply appropriate laws, regulations and legal standards to provide legal counsel to company officers, directors, managers, supervisors and associates regarding legal issues. Use professional expertise to interpret policy, claims processes, and processing for individual claims; potential policy recession, understand individual, worksite and group underwriting processes for life and health insurance policies. Provide advice on policyholder claims and complaints. Represent the company on consumer and regulatory inquiries and complaints, including negotiating with outside parties to resolve potential legal actions. Provide risk assessment and mitigation in fraud investigations and determinations. Stay abreast of new laws and regulations affecting the operations of the insurance business units and non-insurance laws which affect payment of claims and policies, such as trust and estate issues. Drive initiatives identified by Operations Compliance or other areas of the Legal Department, including prompt pay, review of contestable claims, quality audits and training. Develop and manage relationships with Operations business partners, at multiple levels, and other areas of the Legal Department and facilitates open communication with business partners at all levels. Identify risk exposures in current or proposed business practices and actively develops solutions for mitigation.
Qualification and Experience
The candidate should have 5+ years of legal experience. Must have license to practice law in at least one state. Experience practicing law in a mid to large size law firm or insurance company essential. Experience reviewing complex documents and transactional work, including laws, contracts, company procedures, etc to make legal recommendations on procedures needed. Experience with life and health products preferred.