Claims Executive with leadership experience and a proven record of accomplishment in handling TPA, MGA, and MGU program business on a multi-lined basis. Primary, excess, and reinsurance experience ingeneral, auto and professional liability, inland marine, property, workers' compensation and umbrella claims. Committed to the creation of high-performing, productive, collaborative teams within a culture of excellence. Management of personnel and accounts on large exposure nation-wide TPA insurance business. Excellent coverage analysis skills. Focus on data-driven decision-making, trends and results. Oversight of litigation management, large-case settlements, trial monitoring, settlement conferences, and mediations on complex, large-loss claims exceeding $500,000. Best-practice compliance auditing. Employee management skills with results orientated closing ratios. Designated as corporate representative for suits against the company. Licensed insurance adjuster in CT, DE, FL, GA, KY, LA, NH, NM, NC, OK, RI, SC, TX, VT, WV and WY. Outstanding communication, presentation, negotiation and analytical skills. Review and evaluation of monthly loss runs and reports. Microsoft Office and proprietary claims system experience. Consistent record of exceeding expectations.
Assistant Vice President Program ClaimsJan 2015 to Feb 2016 Arch Insurance Company － Darien, CT.
Directed Claim Managers and Administrators for Arch Insurance Company's traditional programs division comprising of twenty-five programs, twelve thousand open claims and $455 million dollars in written premiums.
Six direct reports including Claim Account Managers and Large Loss Specialists supervising TPAs on claims in excess of $50K and/or large loss criteria guidelines.
Jan 2003 to Jan 2015
Worked closely with Program Administrators/Managing General Agents, ensuring their satisfaction with claim handling and service.
Audited TPAs, ensuring compliance with Arch claim handling guidelines and state specific insurance department regulations.
Dashboard analytics, data mining and ability to synthesize bordereaux and loss run exposures.
Presented large cases to senior management, underwriters, and actuaries.
Managed active and runoff multi-lined programs, general and automobile liability, professional liability (fire departments, ambulances, drug treatment and care providers), employment practices, property, inland marine, and worker's compensation.
Conducted due diligence reviews on potential accounts to ensure capability and staff adherence to Arch claims handling guidelines.
Completed multi-state TPA quarterly claim audits, reports and follow up letters with corrective action plans as needed, in addition to coordinating reinsurance audits, SOX compliance audits and internal quality assurance audits.
Responsible for ensuring that TPA data feeds were accurate, developed Access based audit review program, worked with litigation bill review, SIU, and subrogation vendors.
Vice President Program ClaimsFeb 2000 to Dec 2002 Canterbury Financial/Trenwick America Reinsurance Group － Stamford, CT.
Responsible for oversight of a $400 million program book of business, through TPAs by supervising two technical and one clerical employee.
Handled nationwide multi-lined programs: California contractors, worker's compensation, non-standard auto, taxi and trucking programs.
Conducted due diligence reviews on prospective new business, obtained TPA quotes, and prepared TPA contracts, conducted audits, wrap-up meetings identifying areas of concern with recommended corrective measures.
Analyzed adverse trends and monthly reserve changes.
Senior Claim Account ManagerFeb 1994 to Feb 2000 Reliance National Insurance Company
Assigned to the Casualty Risk Services Division, Northeast.
Worked in Commercial Multi-Lined Middle Market Division, Technology, Agri-business, Programs, Petro-Chemical, Captives and Special Risk Accounts with supervision responsibilities over claims and TPAs, customization and marketing of insurance programs for unbundled clients.
Extensive contact with clients, risk managers, corporate claim managers, wholesale and retail brokers, program managers, reinsurance companies and intermediaries.
Obtained TPA quotes for the underwriting team, and prepared TPA contracts.
Coordinated external TPA audits, and conducted wrap up meetings.
Reinsurance billings/facultative and treaty, prepared proof of loss, analyzed coverage issues and prepared coverage opinions.
Reinsurance Claims ExaminerMay 1992 to Jan 1994 Tokio Reinsurance Company
Handled treaty, facultative and quota share reinsurance claims nationwide.
Client contact with ceding companies and intermediaries reviewed and approved submitted proof of losses, performed ceding company claim audits, and wrap up meetings with synopsis of overall results and recommendations.
Multi-lined Claims SupervisorApr 1989 to May 1992 USF&G
Responsible for personal and commercial line claims with direct supervision of four multi-lined Adjusters, four Claim Clerks and the office Auto Appraiser.
Claims RepresentativeDec 1987 to Apr 1989 Cigna － White Plains
Handled general liability and excess claims.
Conducted coverage analysis, issued denials and Reservations of Rights letters.
Claims AdjusterSep 1986 to Dec 1987 Liberty Mutual － Poughkeepsie
Multi-lined claims adjuster, WC, AL, GL and Property, outside field adjuster, performed activity checks and locus investigations.
B.AState University of New York at CortlandGPA: Cum LaudeCum Laude