Results oriented and dedicated professional with 20+ years of Insurance Claims experience. Known for ability to determine priorities, work collaboratively and provide exceptional customer service. Proven ability to investigate, negotiate, mediate and settle complex claims from beginning stage to trial utilizing meticulous documentation. Solid history of settling claims in a timely manner and reaching claim payouts that are acceptable and just. Accomplished team lead in resolving work flow issues within the unit. Skilled in problem resolution accurately evaluating all information and issues and implementing appropriate solutions to limit costs. Valued for ability to provide training to new claim representatives and effectively communicate information regarding procedures and standards.
Areas of Expertise:
Claim Investigation / Skilled Negotiator / Settlement Agreements
Complex Claims / Medical and Liability Knowledge / Coverage Determination
Results Driven / Customer Service /Communication / Collaboration
Organizational Skills /Analytical /Problem Solver
STATE FARM INSURANCE, New Hyde Park, New York May, 1993 – November, 2018
Auto Claims Representative
Evaluated third party claims and first party Uninsured Motorist and Underinsured Motorist Claims. Investigated all aspects in creating the file to gather a full understanding of the claim. Determined value of cases based on liability and extent of damage to persons and property. Worked with external resources to obtain evidence in defense of the Insured. Collaborated with attorneys in the defense of lawsuits and in the discovery and investigation process. Utilized alternate settlement methods including arbitration, mediation and summary jury trials. Negotiated settlement of cases from minimal value to several million dollars. Trained new claim representatives on job functions, procedures and best practices.
●Settled approximately 35% of claims inventory prior to trial resulting in a high rate of case closures and dismissals.
●Held leadership role within the unit for training and workflow issues. Acted as a unit representative on the Bodily Injury Facilitation Committee and participated in workflow studies. Evaluated initial contact questions asked in order to obtain required information for vehicle, location and department involvement. Determined appropriate questions causing less repetition of questions/details which created a high level of customer service and resulted in both time and cost efficiencies.
●Trained and educated new members of the unit in analyzing and reviewing liability and value of damages in specific venue and breaking down injuries to calculate the appropriate value. Acted as subject matter expert and mentor within unit.
●Weighed expenses by factoring in practical and technical considerations in resolving claims. Reviewed trial strategy, expert fees and exposures versus potential verdict.
janine Keyes 631-***-**** firstname.lastname@example.org Page 2
STAPLES Incorporated, various locations, Long Island, NY
Customer Service Representative
Bachelor of Arts in Communication and Business, SUNY Albany, Albany, New York