Hybrid Casualty Claims Adjuster - GoAuto Insurance - Irving, TX
(2024-09)
- Responsible for daily performance of high-volume claim intake, addressing each loss timely and accurately. Reviewing policy language to determine applicable coverage. Identify, evaluate and resolve various coverage issues to be addressed upon investigation.
- Obtaining recorded statements of involved parties to the degree necessary to complete a sound coverage and liability investigation. Verifying and updating all critical data and maintaining proper documentation of loss details as obtained.
- Communicate claims procedures and processes to involved parties verbally and in writing. Address the bodily injury claims of both unrepresented and attorney-represented parties.
- Review damage appraisals for accuracy and consistency, based upon reported loss facts. Review all submitted injury related documentation for accuracy and appropriateness to establish realistic and reasonable settlement ranges. Comply with all required reporting requirements, such as ISO, CMS and Etc. Identify recovery potential and take appropriate steps to pursue company recovery.
Commercial Auto Damage Adjuster/Frontline Bodily Injury Adjuster - Superior Risk Management - Westlake, TX
(2021-04 - 2024-09)
- Responsible for investigating, evaluating, and resolving commercial trucking claims in a variety of states. Promptly establishing contact with involved parties to confirm loss details. Exercised proper judgement to complete the investigation of coverage and liability.
- Reviewing underwriting documents to determine if coverage is triggered, applicable endorsements and policy limits to be applied to each loss. Prepares written communication, including but not limited to settlement letters, disclaimers of coverage and reservation of rights letters.
- Handles non-represented injury, represented injury and property damage claims, including investigating and evaluating those exposures. Timely Identifies exposures with significate severity to triage to the large loss team.
- Requesting appropriate indemnity and adjusting expense reserve amounts to be opened within limits of authority. Exercised proper judgment and decision making to analyze each file exposure. Determines the proper course of action for loss settlement.
- Promptly resolving first and third-party damage mitigation. Provides accurate assessments and negotiates fair and efficient claims resolutions while managing costs. Settles losses according to the documented damage, the language of the policy of insurance, pertinent regulatory and statutory considerations and within granted authority.
Property & Casualty Auto Liability Adjuster - GoAuto Insurance - Baton Rouge, LA
(2019-08 - 2021-04)
- Responsible for daily performance of high-volume claim intake, addressing each loss timely and accurately. Assisting fellow team members as necessary to achieve established performance objectives.
- Reviewing policy language to determine applicable coverage, identifying and addressing coverage issues to be addressed upon investigation. Obtaining recorded statements of involved parties to the degree necessary to determine the extent of liability and coverage. Verifying and updating all critical data.
- Investigate each loss using available evidence obtained, such as driver's statements, independent witness' statements, police reports, vehicle damage, and scene investigations. Applying negligence standards based upon the loss jurisdiction.
- Coordinate with fellow claim representatives to finalize fair and appropriate coverage and liability decisions per scenario. Inputting thorough documentation of all file activity into the claims system, to be reflected clearly and concisely.
- Review damage appraisals for accuracy and consistency, based upon reported loss facts. Communicate claims procedures to involved parties, while setting reasonable expectations. Issuing initial and supplemental payments, to indemnify involved parties. Identify recovery potential and take appropriate steps to pursue company recovery.
Property & Casualty Claims Adjuster II/Total Loss Handler - York Risk Services Group - Mandeville, LA
(2017-05 - 2019-08)
- Evaluate insurance coverage based on claim report, the insurance policy and applicable statutes. Comply with all statutory and regulatory requirements in all applicable jurisdictions.
- Obtain and review medical records. Perform telephone interviews and correspond with all involved parties to secure facts of loss. Obtain and review police reports, hospital records, appraisal reports and repair estimates to evaluate injuries and property damage.
- Determine extent of the financial exposure with respect to claims; set case reserves for use by regulatory authorities. Handle complex litigated claims with limited input from the Unit Manager
- Utilize market evaluations such as Mitchell's and Audatex to determine and negotiate settlement offers to claimant and insureds. Advised Proper documents and/or salvage requirements to resolve each total loss claim. Exercised proper judgment and decision making to analyze the auto claims and exposures to determine the proper course of action to settle the claim.
Independent Adjuster-Total Loss Handler - The Best IRS-State Farm Insurance - Jacksonville, FL
(2016-12 - 2017-05)
- Handled pending total loss claims to completion. Manage first and third-party claims for accidents involving motor vehicles.
- Review and ensure accuracy of payments for settlements Conduct extensive research and follow up with all parties.
- Establish proper indemnity and expense reserve. Maintained and often exceeded the daily tasks assigned
- Accepted and resolved potential escalation calls pertaining to complex issues. Assisted other team members in the handling of claims and the process
- Negotiated complex disposition of claims with insured and claimant parties or legal representatives; identify and implement creative alternative means of resolution to ensure fair claims handling.
Independent Adjuster-Total Loss Handler - E.A. Renfroe-State Farm Insurance - Frederick, MD
(2016-04 - 2016-12)
- Handled pending total loss claims to completion. Manage first and third-party claims for accidents involving motor vehicles.
- Review and ensure accuracy of payments for settlements Conduct extensive research and follow up with all parties.
- Establish proper indemnity and expense reserve. Maintained and often exceeded the daily tasks assigned
- Accepted and resolved potential escalation calls pertaining to complex issues. Assisted other team members in the handling of claims and the process
- Negotiated complex disposition of claims with insureds and claimants or legal representatives; identify and implement creative alternative means of resolution to ensure fair claims handling.
Senior Auto Liability/Total Loss Adjuster - USAgencies-Affirmative Insurance Company - Baton Rouge, LA
(2013-08 - 2016-04)
- Exercised proper judgment and decision making to analyze the auto claims and exposures to determine the proper course of action to settle the claim.
- Interacted extensively with various parties involved in the claim process. Provided analytical skills when necessary to make decisions and resolve complex issues.
- Clearly communicated concise action plans and presented plans for moving a case to conclusion.
- Demonstrated complete knowledge of the claim file process through presentation of actions and responded to the customer questions.
- Processed claims consistent with clients' and corporate policies, procedures and "best practices" and also in accordance with any statutory, regulatory and ethics requirements.
- Proved my ability to think critically, solve problems, plan and organize activities. Embraced new challenges, served insureds and claimants, while negotiating fair settlements. Provided effective communication both verbally and in writing, while building a rapport with the parties involved. Promoted four times within a three-year time frame.
