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Risk Management Customer Service

Location:
Burleson, TX
Posted:
January 12, 2024

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Resume:

Kenneth L. Wilcox

Cell: 214-***-****

Email: ad2pp5@r.postjobfree.com

Location: Lewisville, Texas 75067

Claims Advocate

SUMMARY

Results driven insurance professional with over a decade of experience in the insurance industry, risk management, and contract specialization. Proven leadership experience in managing teams to investigate and settle complex residential and commercial claims via general adjusting and handling of property, auto and bodily injury claims. Expertise in evaluating insurance policies, negotiating settlements, client relations and strategic planning. Proven expertise in effectively representing clients, carriers and companies while developing and implementing comprehensive risk management strategies.

SKILLS

Claims Adjusting

Policy Evaluation and Optimization

Risk Management

Vendor Management

Team Management

Project Management

Safety Compliance

Dispute Resolution

Leadership

Communication Skills

Technical Support

Microsoft Office

Customer Service

CORE COMPETENCIES

Expertise in investigating and settling complex property and casualty claims.

Thorough understanding of insurance policies, coverage, and liability assessment.

Proven ability to lead and manage teams in risk management and loss prevention measures.

Strong analytical skills in evaluating and mitigating risks for commercial clients.

Advanced analytical skills in assessing business interruption, and loss of income claims for commercial losses.

Effective communication with policyholders, claimants, internal teams, and external stakeholders.

Thorough interviews with involved parties to gather relevant information for comprehensive claim investigations.

Personal computer skills, including strong typing ability and proficient use of Microsoft Office.

Excellent speaking, listening, and verbal communication skills.

EXPERIENCE

State of Colorado Attorney General’s Office

General Adjuster/ Risk Management May 2023 – Present

Worked closely with the Attorney Generals office and Risk Management department to analyze and investigate complaints filed with the State to conclude with settlement or denial.

Evaluate State Statutes to determine exposures and liability, ensuring compliance with guidelines and regulations.

Provide expert guidance on regulatory compliance, safety protocols, and loss prevention measures.

Church Mutual Insurance

Commercial and Large Loss Adjuster November 2022 – May 2023

Conducted thorough investigations, interviews, and coverage analysis, to determine the extent of losses and liabilities.

Collaborated with insurance underwriters, legal counsel and experts to determine claim validity.

Prepared detailed claim reports outlining findings, recommendations, and settlement justifications for submission to insurers and clients.

Negotiated settlements with claimants, ensuring fair and timely resolutions within policy terms and guidelines.

Utilized advanced analytical skills to assess business interruption, extra expense, and loss of income claims for commercial clients.

Gallagher Basset

General Adjuster June 2022 – October 2022

Oversaw commercial liability, commercial auto, and bodily injury claims for high-profile clients, including Walmart/Sam's Club, Ulta, Sephora, and upscale restaurants in New York.

Successfully negotiated and settled a diverse range of claims, with settlement amounts ranging from 10K to 5M.

Collaborated closely with carriers, defense counsel, and management to navigate and resolve litigated files efficiently.

Conducted comprehensive investigations, interviews, and on-site inspections to assess damages and determine coverage eligibility.

Alacrity/Chubb Insurance

Commercial Auto/Liability September 2021 – June 2022

Successfully negotiated and presented settlements to clients and claimants, ensuring fair and prompt resolution of claims.

Specialized in handling a significant number of total loss files, demonstrating expertise in managing complex and high-value claims.

Collaborated closely with management on special projects, contributing valuable insights and expertise to enhance overall departmental efficiency and effectiveness.

Managed a portfolio of commercial auto and liability insurance accounts, ensuring compliance with underwriting guidelines and regulations.

Collaborated with underwriters to negotiate terms, conditions, and pricing for new and renewal policies.

Home Owners of America

Claims Adjuster March 2019 – September 2021

Confirmed claims are fairly and accurately investigated and evaluated within established timelines, adhering to customer service standards and quality benchmarks.

Analyzed documentation, including police reports, medical records, and repair estimates, to determine coverage and liability accurately.

Prepared detailed reports outlining claim investigations, assessments, and recommended settlement amounts, maintaining transparency and documentation for internal review.

Conducted thorough interviews with policyholders, witnesses, and involved parties to gather relevant information, ensuring a comprehensive understanding of each claim.

QBE Insurance Company

Claims Adjuster February 2018 – March 2019

Conducted thorough investigations of property damage claims, meticulously determining the cause of loss to assess and process claims accurately.

Identified, analyzed, and skillfully resolved coverage issues for supported clients, ensuring fair and comprehensive claim settlements.

Maintained precise and organized documentation throughout the claims process, meticulously recording all relevant details, and generated comprehensive reports for internal records and client communication.

Choice Solution Services

Property Claims Adjuster February 2018

Successfully resolved attorney-represented and public adjuster-represented claims in collaboration with the litigation team, ensuring adherence to legal processes and regulations.

Effectively managed a high pending caseload, demonstrating strong organizational skills and prioritization to meet deadlines.

Maintained rapport with agents and insureds, fostering positive relationships and addressing concerns promptly to uphold customer satisfaction.

Reviewed and skillfully negotiated settlements for escalated claims, achieving fair and amicable resolutions while considering policy terms and legal implications.

Cunningham Lindsey

Catastrophe Claims Adjuster August 2017 – November 2017

Successfully handled a large influx of pending homeowner claims from Hurricanes Harvey and Irma, ensuring a smooth and timely resolution process.

Negotiated settlements for property damages, contents, and total losses in a fair and satisfactory manner for both insured parties and the company.

Worked closely with the President and Vice President to resolve escalated claims, providing valuable insights and contributing to strategic decisions.

Conducted on-site inspections during catastrophic events to assess property damage and determine coverage eligibility.

Liberty Mutual Insurance

Dispute Resolution Adjuster August 2016 – August 2017

Investigated and resolved customer disputes related to billing discrepancies, service issues, or product concerns.

Conducted thorough reviews of customer complaints, analyzing relevant documentation and communication records.

Assessed the validity of customer claims and determined appropriate resolution strategies.

State Farm Auto Claims

Auto Liability Adjuster July 2012 – June 2016

Interacted with policyholders, claimants, and other stakeholders to gather information and documentation related to the claims process.

Utilized company software and tools to evaluate damage estimates and ensure accurate claim processing.

Collaborated with internal teams, including adjusters and underwriters, to facilitate efficient resolution of claims.

Prepared and submitted comprehensive reports outlining claim details, findings, and recommended settlements.

Liberty Mutual Insurance

Catastrophe Adjuster May 2011 – June 2012

Conducted on-site assessments of property damage caused by natural disasters such as hurricanes, floods, and earthquakes.

Investigated and evaluated insurance claims to determine coverage and extent of loss.

Documented findings through detailed written reports and photographic evidence for claim processing.

EDUCATION

Business Texas A&M Corpus Christi 2006

General Studies Dallas Community College 2005

CTS Bodily Injury Evaluation Course

Rimkus Auto Accident Reconstruction Course

Rimkus Structural Engineering Course

CERTIFICATIONS

PLRB Property Claims Certified

Certified Roof Inspector

Parsons Brinckerhoff Home Inspector

NFIP Certified

State Farm Certified Auto and Property

State Farm Bodily Injury Training

LICENCES

TX, FL, NY, OK, LA, GA, SC

REFERENCES

Keith Hall – Home Owners of America, Manager 469-***-****

Monique Lollar – QBE Insurance, Assistant VP 312-***-****

Ashleigh Hawkins – Choice Claims Solutions, President (469) 403-157



Contact this candidate