Insurance Professional

DARRYL TOLLIVER

661-***-**** cell

Email – **********@*****.***

OBJECTIVE

To incorporate and utilize my consultancy, compliance, sales, and claims experience as a compliance officer, insurance consultant, field claims adjuster, and captive agent, to secure a role in a compliance or consultant function that will best utilize my talent and skills that have been developed within the insurance industry.

QUALIFICATIONS

Innovative professional with a proven track record for achieving results and unique skill set of having compliance and sales experience. Keen awareness of the audit and quality assurance details with the ability to increase business growth, build lasting relationships, capitalize on new revenue potential, and manage all aspects of daily business operations.

oStrong people skills focusing on employee/client relations and agent relations and their needs assessment, marketing, financial management, administration, staff training, supervision, motivation and mentoring.

oWell organized, proactive leader with documented results based on audits of claim files, policies, and vendor contracts.

Naturally inquisitive, quick study, with an ability to grasp and put into practice new ideas, concepts, methods and technologies. Dedicated and self-motivated achiever who obtains results based on relationship building through mentorship, training, persuasion and influence.

Leadership abilities with oral/written communication. Proven problem resolution skills developed at Civil Service Employees Insurance Group (CSE) and California Department of Insurance. Excels in collaborative work environments.

Thrives in performing in pressure situations with time constraints and deadlines while exceeding expectations.

PROFESSIONAL EXPERIENCE

INDEPENDENT INSURANCE CONSULTANT, 2014 to Present

Utilizes and builds wholesale broker and managing general agency relationships with independent agencies through sales, marketing, underwriting, and customer service to improve agency relations and grow the agency commercial book of business. Strong working knowledge of commercial property/casualty coverage and services.

Manages and grows agency networks by promoting programs and educating agencies regarding wholesale broker and managing general agency’s broad appetite by quoting, completing applications, reviewing proposals, binding policies, and cross promoting commercial insurance lines with admitted carriers and surplus lines brokers. Classes include artisans/contractors, roofers, real estate and insurance agents, bars/restaurants/taverns, attorneys, automobile repair shops, landscapers, etc. Commercial lines include general liability, umbrella/excess, commercial automobile, worker’s compensation, garage keepers, professional liability, business owner’s policy, commercial package, surplus lines, etc.

Professional and tactful negotiation and persuasion skills to achieve objectives.

Researches, investigates, and resolves administrative member complaints and appeals.

Documents the results of complaints, appeals, and dispositions at all levels including notification to providers and members.

Assists with Department of Managed Health Care, Utilization Review Accreditation Commission, and Health Plan audit preparation.

Prepares case files on clinical member and provider appeals for medical director review.

Prepares clinical complaint resolution letters under guidance of clinical staff.

Processes, researches, and resolves provider disputes as assigned.

Generates complaint, appeal, and provider dispute acknowledgement and resolution letters and medical records requests.

CIVIL SERVICE EMPLOYEES INSURANCE GROUP, 2009 to 2014

Compliance Supervisor

Utilized SERFF for product rules and forms filings for California, Arizona, and Nevada. Responsible for creating, developing, and implementing a comprehensive, multi-state compliance program for property, casualty, subrogation, special investigations, and call center units to drive culture of compliance. Conducted field underwriting, reviewed policy contracts, and made recommendations to senior Agency and Underwriting management regarding risk exposure and to determine replacement cost value of risks on all Company books of business.

Oversaw claims and underwriting market conduct examinations for California, Arizona, and Nevada and uphold on-going relationships with state insurance departments. Met with Claim and Underwriting staff twice a week to discuss, review, and resolve complex claim matters to ensure complaint claim handling and underwriting behavior.

Handled multi-state Department of Insurance claim and underwriting complaints from customers and provided written responses and follow up to the Department of Insurance in California, Arizona, and Nevada. Supervised over forty claim personnel pertaining to compliance audits, testing, and training.

As Chief Compliance Officer, presented semiannual updates to the Board of Directors and quarterly updates to CEO/President, company house counsel, and executive management team regarding claim, underwriting, and agency operations compliance and regulatory trends and risk issues. Advised on strategic level compliance regarding insurance operations.

Led education and training of claim, underwriting, product development, and agency field operations employees on multi-state insurance regulations, statutes, new legislation, risk, and pertinent insurance industry issues and its impact on insurance operations.

FARMERS INSURANCE GROUP, 2007 to 2009

Claims Compliance Specialist

Lead and initiated regulatory compliance changes for the Catastrophe Response Team and Property Claim Units. Included homeowners, auto, commercial, and construction defects lines of business.

Evaluated multi-state and zone programs, procedures, and new laws to ensure claims operations were in compliance with State and Federal insurance statutes and regulations.

CALIFORNIA DEPARTMENT OF INSURANCE, 2001 to 2007

Senior Insurance Compliance Officer, 2006 to 2007

Leader on insurance regulatory activity and special projects, i.e., Independent Medical Review for Medical Necessity and Wildfires and Earthquake claim complaints, including those to identify, research, and abolish trends in non-compliant activity by insurers.

Associate Insurance Compliance Officer, 2001 to 2006

Mediated and acted as conciliator while directing the licensee/entity to resolve the identified issue, complaint, or violation.

Performed regulatory reviews and claim complaint issues involving, life, accident and health, PPO, title, Medicare supplement, long term care, dental, and long and short term disability, catastrophe (Wildfire, Earthquakes, Landslide, and Flood), surety, professional and general liability, homeowners, time element, mechanical breakdown, pet, construction defects, automobile, commercial, home and auto warranty, and GAP protection.

STATE FARM INSURANCE COMPANIES, 1998 to 2001

Captive Agent

One of the Top New Agents and Business Production leaders

Ranked number 5 in district in Life sales during Founder’s month.

Ranked in top 20% of new agents in selling property and casualty insurance, personal and

commercial lines.

Averaged 25 California Earthquake Authority policies sold per month, which was in top 10% of

new agents.

STATE FARM INSURANCE COMPANIES, 1993 to 1997

Property and Casualty Fire Claim Specialist

Prepared necessary reports detailing investigation and generated timely and accurate reports based on experience and expertise of account procedures, expense and indemnity management, Xactimate estimating techniques, and policy provisions. Extensive experience with litigated first and third party claims, mediation, arbitration, voluntary and mandatory settlement conferences, depositions, and trials.

Presented and evaluated relevant aspects of claim coverage position to upper management to keep them abreast of issues which could expose the client with unknown or improper liability and risk. Performed field underwriting function on inspections of risk location (residential, HOA, business, apartment) for Insurance-to-Value regarding the replacement cost value of the risk.

EDUCATION

UNIVERSITY OF SOUTHERN CALIFORNIA, Los Angeles, CA, 2004

Master of Education Degree, Graduate Certificate in Management of College Student Services

MOREHOUSE COLLEGE, Atlanta, GA, 1992

Bachelor of Arts Degree, Business Administration-Banking/Finance

SKILLS

Microsoft Office Suite; SAS, SPSS, Applied Systems (WINTAM); Nexsure; Lotus Notes; Xactimate Estimation.

OTHERCERTIFICATES/AWARDS

Current California Resident Insurance Producer – Property and Casualty Broker-Agent, Life, Accident and Health. Completed Designations (all in 2011)-Associate in Personal Insurance (API); Associate in Insurance Services (AIS); Associate in General Insurance (AINS); Completed June 2013 - CPCU 500-Foundations of Risk Management and Insurance; Completed August 2011 - CPCU 520–Insurance Operations; Completed September 2010 - Ethics 312-Ethics and the CPCU Code of Professional Conduct Suite.

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