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Claims Examiner (Casualty/General Liability) Resume Example

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CLAIMS EXAMINER (CASUALTY/GENERAL LIABILITY)
Accomplishments
  • Proven track record of success and promotion within the insurance industry.
  • Lead Company is Fast Reasonable and Early Injury Settlements.
  • Assisted and Supervised in the training of many new hires in multiple positions and promoted development of new employees.
  • Served as Lead Adjuster for high exposure complex claims.
Professional Summary
Driven Insurance Professional trained in all aspects of insurance claims handling, Customer Service, inventory management and Claims resolution.. Employs high-level negotiation skills in resolving claims to the satisfaction of all involved parties. Analytical thinker and innovative problem solver who fully understand the power of effective communication.
Education
B.A: Communication Studies (Interpersonal Communication B.G.S)2009KENT STATE UNIVERSITY OH- Kent, Ohio
Skills
  • Strong verbal communication
  • Advanced Knowledge of Standard and Non Standard Auto insurance Policies.
  • Experienced Liability and Coverage Investigator
  • Experienced in Damage Valuation (Property & Casualty)
  • Subrogation and Collections Experience.
  • Licensed Property and Casualty Adjuster (Multiple States)

  • New Project and training management
  • Record of success with diverse customer and client base
  • Served As Arbitrator (Advanced decision making))
  • Client assessment and analysis
  • Strong Negotiator
  • Strong record of resolving claims without further Litigation.
Work History
Claims Examiner (Casualty/General Liability)02/2018 to Current
Sedgwick Claims Management Services Inc. – Independence, OH
  • Examined forms to determine insurance coverage.
  • Interviewed relevant parties to determine claim denial or settlement. 
  • Negotiated and handled complex Third Party Injury Settlements 
  • Investigated and resolved General Liability Claims 
  • Handled Inbound Subrogation demands from third party claimants
  • Mentored  Entry level employees and served as mentor to new hires
  • Assisted in Litigation matters and large losses
Subrogation Specialist/ Arbitration Panelist04/2016 to 02/2018
Progressive Casualty Insurance – Beachwood, OH
  •  Served as Arbitration Panelist reviewing complex liability and damages disputes. Entered binding liability decisions to resolve disputes between major insurance carriers.
  • Completed Arbitration Forums training and passed certification test to become arbitrator
  • Handled complex third party subrogation demands from property and casualty insurance providers.
  • Reviewed and assisted Outside defense in preparation of claims handled in litigation.
  • Evaluated all evidence with the ultimate goal of creating positive outcomes for client's claims.
  • Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
  • Maintained low inventory levels while not sacrificing the quality of reviewed files.
  • Followed up with the insured individuals regarding premium and deductibles payments.
Claims Casualty Specialist01/2014 to 05/2016
Nationwide Insurance Company Bodily Injury Adjuster – Highland Hills, Ohio
  • Negotiated and Settled Injury claims with both first and third party claimants
  • Handled Non Standard and  High Risk insurance claims with attorney represented parties in highly litigated venues.
  •  Displayed proven track record of success and compliance while achieving claims handling proficiency.
  • Promoted professional work environment and training to new hires and served as mentor.
  • Evaluated all evidence with the ultimate goal of creating positive outcomes for client's claims.
Casualty Claims Adjuster01/2013 to 01/2014
National General Insurance Cor – Cleveland, Ohio
  • Handle Third party injury claims resulting from motor vehicle accidents Negotiated injury settlements with third parties and attorneys to resolve injury claims Evaluated wide range of injury claims from mild to complex injuries Settled first party injury claims Reviewed medical records and bills associated with complex injuries, and demand packets served as senior mentor to claim reps and assisted in both coverage and liability investigations Helped trained new hires to department assisting with both coaching and career development.

Senior Material Damage Claims Adjuster01/2012 to 01/2013
GMAC Insurance/ National General Insurance Co – Cleveland, Ohio
  • Handled and negotiated complex automotive and property damage liability claims.
  • Handled first party Medical Injury claims related to automobile accidents Negotiated and settled subrogation demands from claimant carriers and legal entities.
  • Assisted in automobile repair processes by redlining appraiser and body shop estimates.
  • Served as senior mentor to new hires assisting in training and evaluation process Consistently met or exceeded performance metrics of job qualifications.

Property Damage adjuster/Senior Auto Claims Adjuster11/2011 to 10/2012
Progressive Insurance – Mayfield Heights OH
  • Handled and negotiated multiple vehicle automotive property damage liability claims on daily basis Investigated, processed, and handled multiple disputes regarding liability between first and third parties.
  • Completed investigations to confirm claimed damages consistent with applicable insurance coverage Communicated effectively and clearly standard insurance policies Consistently met or exceeded performance metrics of job qualifications.
Insurance Sales Agent01/2010 to 01/2011
Homesite Insurance Company of the Midwest – Akron, OH
  • Sold and negotiated insurance policies and products to diverse clientele in call Aug 2015 center environment.
  • Met and exceeded expected sales quotas.
  • Performed many administrative duties in servicing and updating customer profiles and policies.

Additional Information
  • Volunteer work, Serve as Youth Basketball Coach at YMCA
  • Speak to youth groups and community organizations about physical and mental health awareness. 
  • Serve as mentor to youth throughout multiple community organizations
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Resume Overview

Companies Worked For:

  • Sedgwick Claims Management Services Inc.
  • Progressive Casualty Insurance
  • Nationwide Insurance Company Bodily Injury Adjuster
  • National General Insurance Cor
  • GMAC Insurance/ National General Insurance Co
  • Progressive Insurance
  • Homesite Insurance Company of the Midwest

School Attended

  • KENT STATE UNIVERSITY OH

Job Titles Held:

  • Claims Examiner (Casualty/General Liability)
  • Subrogation Specialist/ Arbitration Panelist
  • Claims Casualty Specialist
  • Casualty Claims Adjuster
  • Senior Material Damage Claims Adjuster
  • Property Damage adjuster/Senior Auto Claims Adjuster
  • Insurance Sales Agent

Degrees

  • B.A : Communication Studies (Interpersonal Communication B.G.S) 2009

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