Michael Doerning, CPCU, AIC, SCLA

**** ******* ***** ********, **. 96816

808-***-**** adglt4@r.postjobfree.com linkedin.com/in/michael-doerning

Claims Manager - Multi-Line Adjuster – Risk Manager

Professional Employment Organizations (PEO) – Third-party Administrators (TPA) – Property & Casualty Insurance

Workers’ Compensation - Employment Practice Liability – Commercial Underwriting - Special Investigations

Expertise:

Claims Adjusting

Underwriting

Risk Management

Client & Account Relationships

Surveillance

Appraisals

Litigation

Fraud Investigations

Human Resource Deployment

Attracting, Hiring & Mentoring Staff

Training & Development

Performance Metrics

Professional Experience

MAKAI HR / MALAMA RMC, LLC., Honolulu, HI June 2018 – Present

Director of Claims, Underwriting and Risk Management

A boutique consultancy specializing in Risk Management Services for large employer groups in the state of Hawaii. Services include Strategic Advisory & Program Management, Carrier Negotiation, Claims Management / TPA services.

Accountable for the strategic and operational success of a growing PEO with more than 15,000 worksite employees. Lead multiple functions including claims, underwriting and risk management. Influence the growth and profitability of the organization as a member of the leadership team. Attract, hire and retain a team of high performing associates focused on organizational values and priorities.

Direct the successful adjudication of workers’ compensation, employment practice liability, temporary disability & unemployment claims in the organization’s third-party administration unit. Champion a team of adjustors and administrators to successfully handle 150 cases per month with an average closing ratio of 87%.

Facilitate underwriting decisions for all commercial insurance lines including WC, TDI, EPLI, UI, MEL, USL&H, Maritime & Health Care. Quoted 25 new accounts per month with $375K in annual premium.

Consult key clients on risk management strategies to improve outcomes while confirming compliance with OSHA & HIOSH rules and regulations. Manage 75 accounts. Able to save clients $250K per year on average as a result of risk management mitigation.

Survey client locations including safety walk-throughs, facility inspections and quality assurance reviews. Completed 50 surveys annually.

Draft companies’ drug testing policies, employee safety handbooks and return to work policies.

Present safety training on a variety of topics for clients through a combination of in-person classes, virtual presentations and on-line safety resources.

Arrange the set-up of insurance captives. Lead a team of account managers on Oahu and neighbor islands to successfully service the product. Generated $15M in annual premium.

Coach, develop and mentor staff. Educate adjustors on claims best practices. Institute key performance measures tied to desired client outcomes. Use data analysis to measure, communicate and guide team and individual performance improvement.

Promote industry leading client service by driving commitment to client satisfaction through all levels of the organization.

PROSERVICE, Honolulu, HI January 2016 – June 2018

Senior Workers’ Compensation Adjuster

Hawaii’s largest PEO Captive Insurance carrier with over $25M in annual premium.

Investigated and adjusted complex cases. Hired, trained and mentored five junior adjustors including case reviews and performance evaluation based on key performance indicators.

Investigated complex litigated cases. Analyzed forensic evidence and conducted interviews. Hired experts and reviewed evaluations. Directed legal counsel and outside vendors. Negotiated claim settlements. Attended hearings and appeals for the company. Expertly controlled disability management, return to work, vocational rehabilitation and medical audits. Adjudicated on average 85 caseload with quality scores of 93% and a closing ratio of 90%.

Led a staff of five adjustors by prioritizing and delegating tasks and monitoring the timely performance on key indicators such as closures, return to work, plan of action, and reserving.

FAIRMONT SPECIALITY (CRUM & FORSTER INSURANCE), Honolulu, HI September 2002 – January 2016

Claims Specialist / SIU Coordinator

Adjusted workers’ compensation, third-party property, personal automobile, business automobile, product defect, commercial general liability, professional liability and garage liability claims. Served as Special Investigative Unit Coordinator for workers’ compensation and casualty units by directing and pursuing action involving potentially fraudulent claims.

Liaised with plaintiff and defense attorneys to resolve litigated claims. Presented cases in arbitrations, mediations and settlement conferences.

Represented insurance company by testifying at insurance hearings and before the Hawaii Grand Jury.

Prepared and delivered staff training for fraud recognition. Wrote and implemented fraud handling guidelines.

Served as both President and Vice-President of the Hawaii Special Investigator Unit.

PROGRESSIVE INSURANCE, Honolulu, HI 2001 – 2002

Special Investigator (Level II)

Investigated personal lines automobile, personal injury protection and casualty claims. Appraised damaged vehicles, instigated subrogation and settled total losses. Ordered background checks, interviewed witnesses, reviewed surveillance and analyzing credit reports. Worked with Police, National Insurance Crime Bureau and State Fraud Unit on fraud claims.

Established Hawaii’s chapter of WSATI (Western States Auto Theft Investigators).

Led Western region in first call settlements of bodily injury claims.

Lead investigator of cases involving fire and theft.

Prior work experience includes serving as property & casualty adjustor and as a private investigator in Georgia, Virginia and California.

Education & Certifications

Bachelor of Science in Criminal Justice

California State University, Los Angeles, California

Dean’s List, Cum Laude, Phi Kappa Phi (professional law enforcement honor society)

Certified Property Casualty Underwriter (CPCU), The Institutes at Malvern, Pennsylvania

Associate of Science in Claims (AIC), The Institutes at Malvern, Pennsylvania

Senior Claim Law Associate (SCLA), American Educational Institute at Basking Ridge, New Jersey

Courses

Legal Principles Specialist, Fraud Claim Law Associate, Casualty Claim Associate, Automobile Claim Associate

License and Certificates

Hawaii State General Adjusters License

Litigation Handling /Hawaii State Legal/Alternative Dispute Resolution/Bodily Injury Evaluation/Soft Tissue Injury Claims/Medical Audits/Accident Scene Reconstruction/Workers’ Compensation Disability Evaluation

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