Results-oriented Claims Adjuster bringing hands-on law enforcement experience and exceptional leadership and communication skills. Background includes criminal investigation, insurance fraud and surveillance. Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes. Insurance Adjuster skilled in investigating and analyzing liability concerning personal, casualty or property loss. Proven history of leveraging excellent negotiation skills to facilitate settlements. Excellent communication skills demonstrated through 10 years of experience interviewing specialists, witnesses and claimants to compile information. Knowledgeable Claims Investigator specializing in auto and property inspections. Trained in local, state and federal fraud statutes with high level of integrity. Diligent Insurance Collector versed in accident investigations, documentation and management. Passionate about quality and customer satisfaction with record of consistently exceeding company goals. Claims Adjuster with deep experience in confidential litigation claims. Superbly positioned to investigate, evaluate, and settle Bodily Injury claims. Excellent abilities to decipher fraudulent activities, analyze data, confer with legal counsel.
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- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Maintained contact with claimants and attorneys to determine treatment status.
- Directed and coordinated various investigations conducted by field investigation team.
- Evaluated all evidence with ultimate goal of creating positive outcomes for client's claims.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Examined claims forms and other records to determine insurance coverage.
- Organized, planned, and documented materials for casualty claims.
- Documented all investigation activity and presented reports to management.
- Prepared litigation evaluation documents for managers and legal personnel.
- Negotiated Bodily Injury settlement agreements to resolve disputes.
- Trained other claims staff members on proper handling and evaluation of injury claims.
- Substantiated legitimate claims and denied unjustified claims.
- Drafted investigative reports covering all phases of investigation in each case.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Investigated legal issues pertaining to Bodily Injury claims.
- Prepared summaries of damage, payments and policy coverage.
- Answered questions posed by insured and attorneys.
- Evaluated insurance policies and analyzed damages to determine coverage.
- Reviewed police reports, medical treatment records and physical property damage to determine extent of liability.
- Verified insurance claims and determined fair amount for settlement.
- Evaluated all evidence with ultimate goal of creating positive outcomes for client's claims.
- Maintained contact with claimants and attorneys to determine treatment status.
- Organized, planned, and documented materials for homeowner claims.
- Prepared summaries of damage, payments and policy coverage.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Determined liability outlined in coverage and assessed documentation such from police and healthcare providers to understand damages incurred.
- Evaluated original investigation reports and documents to resolve secondary concerns.
- Analyzed information gathered by investigation and report findings and recommendations.
- Examined claims forms and other records to determine insurance coverage.
- Maintained excellent attendance record, consistently arriving to work on time.
- Examined potential loss stemming from catastrophe, severity or frequency of possible loss.
- Focused on maintaining profitable business segment for company.
- Controlled loss by assessing risk, conducting system analysis and recommending policy solutions.
- Supported marketing and sales activities with subject matter expertise.
- Applied knowledge of underwriting guidelines to maintain compliance with applicable regulations and company standards.
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School Attended
- Park University
Job Titles Held:
- Claims Adjuster
- Catashtrophe Claims Adjuster
- Bodily Injury Adjuster
- Sr Underwriter
Degrees
- Bachelor of Arts
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