Claims Examiner Bodily Injury
Resume:
THERON S. MERCOMES
***** **** ******** *****, *** City West, AZ 85375
*********@*****.***
623-***-****-Home; 816-***-**** Cell
HONORABLY DISCHARGED VETERAN
PROFESSIONAL EXPERIENCE:
Proven Claims, Risk Management Professional with Entrepreneurial Skills
Senior Commercial Lines Property Claims Examiner
RepWest-(A captive of U-Haul); Contract Assignment with Western International Staffing
Phoenix, AZ
Handled Liability Property Claims on a Nationwide basis. The losses ranged from minor damaged building, homes, to automobiles and other real property. Assigned losses to Appraisers and other field personnel for the scope of damages of other related costs. Handled claims from inception to closure, negotiating settlements and effectuating payments, and referrals to underwriting as appropriate.
Senior Global Blockchain Recruiter
BlockchainCareerbuilders.com
Phoenix, AZ
06/2017-05/2019
Managed complete recruiting lifecycle — client service, contract staffing and executive search projects from kickoff through final offer, negotiation, and acceptance process. Clients include both Fortune 500 and startups. Principal in the business, which was a start-up.
Senior Bodily Injury Claims Examiner
03/2015-06/2017-Commonwealth Casualty Company-Phoenix, AZ
•Handled bodily injury, litigated UM/UIM, and fatality losses to conclusion
•Recognized low impact losses, forwarded for biomechanical review and analysis
•Utilized SIU for obtaining surveillance, videos, reports, and other pertinent information
•Reduced claims payment and increase claims savings with the utilization of the above
Senior Bodily Injury Claims Examiner/Litigation Specialist
05/2007 –03/2015-Insurance Recruiting Specialists-Phoenix, AZ
Contract positions with Gallagher-Basset Services, Safeway Corporate (Risk Management/Claims Department), Gainsco Insurance (Automobile Insurance Company), and The General Automobile Insurance Company; Handled complex, high exposure, bodily injury, fatality, and litigated matters on a nationwide basis. Handled slip/trip and falls, premises liability, and food poisoning claims.
Investigate and evaluate claims, taking statements, review of police reports, witness statements, review of estimates and damages, medical records and reports; provided excellent written reports for management’s cognizance and utilization. Maintain a current and accurate diary system,and handle files from inception to closure; versed on spoliation issues and their implications
Bodily Injury Claims Examiner, VI – Commercial Trucking
04/2006 – 04/2007 -- Swift Transportation Company; Phoenix, AZ
•Provided resolution of large commercial complex and serious losses with exposures of $100,000 and above; evaluated claims based on liability, damages and other relevant issues
•Directed defense counsel, bio-mechanical experts, economists and other professionals
•Attended mediations nationwide and utilized other alternative dispute resolution strategies
Directed claims counsel and other experts, such as biomechanical engineers, and economists
•Utilized ADR, mediation resolution strategies; prepared litigation plans and budgets
•Provided tactical and strategic file trajectory, and accounted for 70% of the unit’s closures
•Recognize, document, and refer fraudulent and or suspicious claims and seek restitution where subrogation exists
01/2003 – 09/2005 Claims Overload Systems; Overland Park, KS
Claims Examiner-Personal and Commercial Lines
•Contract Positions with CNA, Allstate, and Farmers Insurance companies
Provided analysis and resolution of large and complex losses involving litigation management
•Handled Commercial Automobile and General liability injury claims
•Investigated, analyzed liability and resolved Automobile, and General Liability Claims. Manage File inventory to timely resolutions (high priority and diary system files worked first.) Provide status update for management’s, client, and other intermediaries’ cognizance and utilization.
06/1998 – 12/2002 American International Group (A.I.G.C.S.) Overland Park, KS
Claims Representative – Commercial Trucking/Transportation Unit
Assigned to large commercial accounts; J.C. Penney, IBM, Continental Airlines, American Airlines, Cassens Transport Company, Ralston Purina and the GAP; Worked all 50 states and was awarded the Southeast “Star Award” for the highest closing ratio in the office, and in handling in excess of 1200 claims per year
•Identified, negotiate and convey settlement and coverage decisions
•Created and sent professional internal and external quality correspondence specific to claim issues;
•High file quality, excellent closing ratios with sound decisions predicated on supportable determination. Superior results through solid liability investigations to include police reports, witness statements, evaluation of medicals for settlement range, and negotiations.
Prior work, for 10 years in Saudi Arabia for a joint-venture firm as a Manager of Insurance (both Property and Casualty and Life/Health Insurance.) Managed a staff of 5, and was responsible for the placement, risk management, and claims administration of coverages ranging from Jet Fleet Aviation to Workman’s compensation. Additional administration of the Group Insurance Life and Health Plan.
EDUCATION/CERTIFICATIONS:
California State University, Los Angeles, CA; Business Administration
Emporia State University, Emporia, KS; Education/Business
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