Claims Adjuster General Liability
Resume:
Eudilma Sole-Kaifman
SENIOR CLAIMS ADJUSTER/MANAGER - BODILY INJURIES - HOMEOWNERS - AUTO - SLIP
AND FALL - PROPERTY - MEDICAL MALPRACTICE - COMMERCIAL INSURANCE (MASS TRANSPORTATION AND TRUCKING)
Weston, FL 33331
*******@*****.***
Strong organizational and communication skills. Professional Florida Claims Adjuster and Manager with over twenty (20) years of Bodily Injuries, Medical Malpractice, Homeowners Insurance, Property and Liability Legal/Litigation Claims Handling and Claims Adjusting and twenty (20) years of advanced office experience seeks Homeowners/BI Senior Remote Claims Adjuster/Supervisor/Manager position. Specialized in PIP [Personal Injury Protection] Liability, Homeowners, Property Damage, Life Sciences, General Liability, Product Liability and Risk Management. I want to be part of your organization, learn, and continue my hard work, to the best of my ability to further my career. To seek a challenging position, where my experience, education, and accomplishments will contribute to the success of your organization. I am upbeat and dynamic with a high-energy level and a positive attitude. Enjoy people and have excellent telephone and communication skills (oral & written). Ability to work well under pressure in a team environment. Able to demonstrate passion for taking care of customers with integrity while having fun.
Fully bilingual in Spanish and English.
Authorized to work in the US for any employer
Work Experience
Senior Liability Claim Adjuster - Commercial General Liability Claims Adjuster - Auto and General - Trucking - Property - Slip and Falls - Litigation Ascendant Commercial Insurance, Inc
August 2023 to April 2024
A General Liability Adjuster is a professional responsible for investigating and managing insurance claims related to general liability coverage. This type of coverage typically protects businesses from claims involving bodily injury, property damage, and personal injury only with circumstantial evidence after a loss. General Liability Adjusters assess the circumstances surrounding a claim, gather relevant evidence, review policy terms and conditions, and determine the extent of the insured's liability and coverage, being able to differentiate both of them. They may conduct interviews with parties involved, such as claimants, witnesses, and experts, to gather information and assess the validity of the claim. Additionally, General Liability Adjusters negotiate settlements with claimants, coordinate with legal counsel when necessary, and ensure compliance with insurance regulations and company policies. Strong analytical, communication, and negotiation skills are essential for success in this role, as well as a thorough understanding of insurance principles and liability laws. LIFE SCIENCES LIABILITY
Dynamic Claims Insurance-San Diego, CA
2015 to August 2023
Medical Malpractice Liability Adjuster - Pre-and Post-Litigation - Life Sciences Liability Adjuster Conduct thorough investigations and assessments of liability, causation, and damages in both non litigated claims and litigated cases.
A life sciences liability position typically involves assessing and managing risks associated with products or services in the life sciences industry, such as pharmaceuticals, biotechnology, medical devices, and healthcare. Responsibilities may include evaluating potential liabilities related to product development, testing, manufacturing, marketing, and distribution. This role often involves working closely with legal teams, regulatory agencies, and other stakeholders to ensure compliance with relevant laws and regulations while minimizing exposure to liability claims. Additionally, the position may involve conducting risk assessments, implementing risk mitigation strategies, and providing guidance on liability- related matters to the company's leadership.
Senior Property and Casualty Pre and Post Litigation Adjuster Castle Key Management (Allstate)-Weston, FL
October 2022 to May 2023
A property and casualty adjuster is a professional who investigates insurance claims related to property damage or personal injury covered under property and casualty insurance policies. Their primary responsibility is to assess the extent of the damage or loss, determine the validity of the claim, and negotiate settlements with policyholders or claimants. Property and casualty adjusters typically visit the site of the incident, gather evidence, interview witnesses, review policy terms and conditions, and work with various parties involved, such as contractors, medical professionals, and legal representatives. They must possess strong analytical, communication, and negotiation skills to effectively manage claims and ensure fair and timely resolution for all parties involved. Maintains claims files and records for the purpose of documenting actions and ensuring compliance with participating policies and mandated legal requirements. Oversees the claims handling and third party provider (e.g. litigation on complex cases and plans, etc.) for the purpose of ensuring the claims are being handled according to the legal regulations of multiple states.
Prepares statistical summaries, evaluations and reports, oral presentations. SENIOR CASE MANAGER
The Law Offices of Pacin & Levine-Miami, FL
August 2020 to August 2022
Assist attorneys with all aspects of case management, including docketing deadlines, billing, and providing reminders as necessary
Coordinate between attorneys, staff, and outside vendors to manage the law firm’s case load, present case summaries/updates, and ensure that deadlines are met Organize and maintain all case files, and information concerning engagement, whether electronic or paper, in accordance with the law firm policies
Conduct legal research to obtain documentation regarding health insurance, social security, medical records, and medical providers
Draft legal documents for attorney review
Review legal documents to ensure adherence to all legal requirements Consult with attorneys and provide recommendations with regard to cost and time-effective ways to accomplish the client’s goals
Communicate case status with clients and outside counsel as requested SENIOR PRIVATE INVESTIGATOR
Command Investigations-Miami, FL
December 2019 to March 2020
Temporary assignment as a private investigator. Received files from clients and performed investigations of all types as needed. Prepared reports, pictures, videos, surveillance, background checks, etc. Traveled throughout the state of Florida, essentially South Florida, took recorded statements, EUOS, field Investigations in general.
Also, performed several investigations for Workers Compensation, Liability, and Property Damage Claims. Wrongful death, and medical malpractice.
SENIOR LIABILITY CLAIMS MANAGER II - FIELD AND IN OFFICE Optacomp-Fort Lauderdale, FL
2009 to 2015
Senior Liability, Property Damages Slip and Fall, Risk Management Medical Malpractice Liability and Complex Claims for settlement and/or Trial in a timely manner. Supervises 35 Claims Adjusters and Nurse Case Managers. Communicates with Attorneys, Defense, Plaintiffs and Adjusters to make sure all bills are paid timely and all Claims investigated promptly.
Takes analytical decisions regarding the files, working in conjunction with Director to deliver prompt and accurate reviews of Claims Files and Demands to Client. Performs multi-task functions, regarding paperwork, deadlines, communication with Insureds, prompt resolution of cases within Litigation.
Handle Complex High Exposure Auto, Slip and Fall.
SENIOR LIABILITY CLAIMS ADJUSTER II - RISK MANAGEMENT Broward County Risk Management Litigation-Fort Lauderdale, FL 2007 to 2009
Auto Liability, Property Damages Slip and Fall, Risk Management- Handles account for Mass Transit, Parks and Recreation, all Broward County
Handle high exposure Liability and Complex Claims for settlement and/or Trial in a timely manner. This includes investigating and determining liability, reviewing exposure, analyzing damages for bodily injury, Property Damage, Slip and Fall, negotiating settlements, identifying subrogation potential, and assigning and monitoring Insurance Adjusters and Defense Counsel. Advanced handling of casualty claims best practices, medical terminology and liability analysis. Handling the investigation, negotiation and settlement activities used to resolve severe bodily injury claims. Use of Xactimate (mostly reviewing reports).
Communicates with Attorneys, Defense, Plaintiffs and Adjusters to make sure all bills are paid timely and all Claims investigated promptly.
Takes analytical decisions regarding the files, working in conjunction with Manager to deliver prompt and accurate reviews of Claims Files and Demands to Client. Performs multi-task functions regarding paperwork, deadlines, communication with Insureds, prompt resolution of cases within Litigation.
SENIOR PIP LITIGATION CLAIMS ADJUSTER - TEAM LEADER UNITED AUTOMOBILE INSURANCE COMPANY-Fort Lauderdale, FL 2001 to 2007
Personal Injury Protection, Auto Liability, Property Damages Slip and Fall, Risk Management- Handles account for DMA and AAA Multi-State
Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim. Interacts extensively with various parties involved in the claim process, and supervises Adjusters. Able to clearly communicate concise action plans, and present plans for moving the case to conclusion. Will demonstrate complete knowledge of the claim file process through presentation of actions and responses to client questions.
Processes claims consistent with clients' and corporate policies, procedures and "best practices" and also in accordance with any statutory, regulatory and ethics requirements. Demonstrated ability to comply with carrier reporting and threshold requirements. Able to recognize and pursue excess insurance recoveries. Incumbents will have the ability to handle a full case load, with proven ability to handle cases of increased severity Education
Master's in Pre Medicine
Keiser University-Ft Lauderdale - Fort Lauderdale, FL June 2016 to October 2019
Bachelor's in Interdisciplinary Studies
Keiser University - Fort Lauderdale, FL
June 2017 to November 2018
Master's in LAW
Universidad Central de Venezuela - Caracas, Distrito Capital October 1992 to July 1996
Skills
• Investigations
• Microsoft Word
• Operations Management
• Security
• Time Management
• Training
• Writing Skills
• Surveillance
• Legal Research
• Negotiation
• Microsoft Office
• Italian
• Legal Drafting
• Journal Entries
• Spanish
• Management
• English
• Office Administration
• Microsoft Excel
• Human Resources
• Organizational Skills
• Microsoft Powerpoint
• Leadership
• Case Management
• Customer service
• Communication skills
• Bilingual
• Microsoft Outlook
• Office Management
• Medical Malpractice (10+ years)
• Medical billing
• Microsoft Outlook
• Microsoft Office
• Communication skills
• Malpractice law
• Negotiation
• Workers' compensation law
• Analysis skills
• Medical terminology
• Leadership
• Paralegal experience
• Legal research
• Presentation skills
• Supervising experience
• Risk management
• Construction
• Office management
• Marketing
• Operations management
• Manufacturing
• Training & development
• Medical records
• ICD-9
• Personal injury law
• Interviewing
• Research
• CPT Coding
Languages
• Spanish - Expert
• English - Expert
Certifications and Licenses
CPR/First Aid
CPR
All Claims Adjuster
Present
Masters Degree in Law
July 1997 to Present
All Claims Adjuster
March 1999 to Present
Driver's License
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