Edward D'Andrea

Directly handled and/or assisted in monitoring, reviewing and coordinating the activities involving general liability claims. Managed a panel of TPAs and performed due diligence on potential acquisition target to ensure claims were properly reserved.

Sr. Technical Claims Specialist at R&Q LEGACY (2022-01 – Present)

Directly handled and/or assisted in monitoring, reviewing and coordinating the activities involving general liability claims. Managed a panel of TPAs and performed due diligence on potential acquisition target to ensure claims were properly reserved.

• Worked with and assisted Business Development Team to evaluate claim level reserves of potential acquisitions. Review includes primarily General Liability (GL, Bodily Injury, Construction etc.).
• Established reserves, directed investigations, evaluated coverage and made settlement recommendations on very high exposure claims.
• Managed various Third-Party Administrators handling of the Company's General Liability claims.
• Provided specific claims information to senior management relative to all new notices of loss.
• Managed the diary control of reported cases to ensure maintenance of proper reserves to reflect the company's exposure and adequate notice to reinsurers, and recovery of specific amounts when payment exceeds the company's retention.
• Participated in Audits relating to assigned claims portfolio.

Sr. Claims Specialist at YORK RISK SERVICES/SEDGWICK CLAIMS (2014-01 – 2022-12)

Investigate, evaluate and negotiate large exposure GL, PL and Auto Liability claims. Responsible for managing the indemnity and expense financials of claims, with an eye towards timely resolutions.

• Identify and flag coverage issues and provide recommendations on coverage questions.
• Draft and issue ROR and Declination letters, as warranted.
• Participate with and direct counsel on all aspects of litigated claims activities.
• Identify timely and clear exposure rationales, to support reserves, negotiation strategies and settlements.
• Develop and maintain cohesive relationships with Insured's, Broker's and other involved business partners.

Sr. Claims Specialist at ZURICH (2011-01 – 2014-12)

Responsible for resolving a large EPL claims pending, comprised of primary and excess files. Responsible for managing indemnity and expense payouts while achieving timely resolutions of claims.

• Identify and flag coverage issues and provide recommendations on coverage questions.
• Draft and issue ROR and denial letters, as warranted.
• Participate with and direct counsel on all aspects of litigated claims activities.
• Identify timely and clear exposure rationales, to support reserves, negotiation strategies and settlements.

TPA Manager at UNITED AMERICA INSURANCE GROUP (2002-01 – 2010-12)

General Liability, Trucking, Equine, Non-subscribers Workers Comp. Managed TPA accounts to ensure quality claims handling, including timely reporting and reserve adjustments.

• Evaluated coverage issues and authorized ROR and Coverage Declination letters, issued by the TPA.
• Reported to reinsurers on cases that impacted the respective treaties.
• Audited TPA's for contract compliance and claims quality control.
• Completed and presented audit reports for identified results.
• Used data mining to identify strengths and areas of improvement.
• Provided hands-on experienced oversight direction, to help reduce loss ratio on liability book of business from 90% to 50%.
• Compelled TPA to follow a high standard of claims handling procedures and practices.
• Properly identified coverage issues and executed appropriate strategies to evaluate and dispose of coverage actions.
• Established credibility with the TPA by making reasonable, timely and supported claims decisions.
• Completed objective audits and provided meaningful and measurable audit reports and audit wrap-up discussions.

Team Leader – ESIS TPA Division of ACE USA/CIGNA at CIGNA (1998-01 – 2002-12)

Supervised general liability and auto claims for eight direct reports. Responsible for evaluating and making decisions on cases that exceeded the adjustor authority levels.

• Participated in the establishment of policy for best practice claims handling and account management procedures on an office-wide level.
• Participated in marketing meetings with existing and prospective customers.

Claims Specialist at CIGNA REINSURANCE DIVISION (1995-01 – 1998-12)

Evaluated and processed Facultative and Treaty Reinsurance Claims. Exposures presented by ceding companies consisted of multi-line, Environmental and Long-Term Exposure claims.

• Conducted on-site claim reviews, retrocessional reporting and pursued commutation agreements.

Claims Team Leader – Professional Liability at CIGNA (1993-01 – 1995-12)

Responsible for successful resolution of reserved files over $100M. Supervised claims handling in the A/E, Accounting, Lawyers, Insurance Agents, and Aviation and Directors & Officers lines of business.

Professional Liability Specialist at CIGNA (1988-01 – 1993-12)

Assumed handling of over 150 multi-jurisdictional files with identified reserve and reporting deficiencies. Promptly and concisely evaluated files, adjusted reserves, and produced timely reports.

• Aggressive, focused direction of and participation with defense counsel, to minimize the financial impact of claims and significantly reduce loss dollar payout.
• Additional responsibilities included high value General Liability and Auto Liability claims.

Senior Claims Representative / Claims Adjuster, UAC Division at CNA INSURANCE COMPANY (1982-01 – 1988-12)

Successful investigation, evaluation and resolution of General Liability, Auto Liability, Architects & Engineers and assorted Professional Liability claims. Outside Claims Adjustor experience.

Bachelor of Science in Business Administration – Rutgers University – Camden