HENRY DEALBA

**** ******* ******

Thousand Oaks, CA 91360

805-***-**** / 805-***-****

adltip@r.postjobfree.com

PROFILE

Bilingual claims professional with twenty plus years of carrier and TPA experience in commercial and personal lines

bodily injury, general liability, SIU, med pay, PIP, litigation, property and supervision

Expertise in coverage analysis, office and field investigations, resolving liability disputes, litigation management,

attending Small Claims Court and other legal proceedings

Instructed and trained employees regarding changes in claims, policy contracts and procedures as well as customer care.

Highly adaptable self-starter, organized, quick learner, reputation for dependability and credibility

Team oriented and able to work independently

Excellent bilingual communication, customer service and customer care skills

Long standing relationship and interaction with the National Insurance Crime Bureau and Department of Insurance

Fraud Bureau

EMPLOYMENT

CUSTARD INSURANCE ADJUSTERS- CA-June 2017-Present West Covina, CA

Investigator/Adjuster

Handle investigations for Federal Express ground from beginning to resolution

Handle claims for UPS from beginning of the investigation to resolution

Handle other claims which include Swift trucking and SAIA trucking

Being called out when a serious injury has occurred which includes being available from 24/6

Attending MSC’s and mediations for Liberty Mutual when called upon

Assisting and taking statements from individuals who speak Spanish only

Claims Resource Management Inc. Acton, CA

Claims Adjuster (Temporary Assignment) October 2016 to March 2017

Handled and investigated general liability, premises liability, food related product liability claims which included the hospitality, food service industry including Chuck E Cheese account throughout the United States. Verified if the claimant was a Medi-Care recipient.

Schneider Associates and Schneider & Associates Thousand Oaks and Burbank, CA

Claims Investigator May 2015 to October 2016

• Assigned and investigated personal and commercial liability, auto BI, PD, MD; general and premises liability; property including

theft, water, fire / smoke arson; workers’ compensation (AOE / COE) claims from throughout the L.A. and Ventura County areas.

Carnegie General / Platinum Claims Newbury Park, CA

BI-PD SIU Claims Adjuster February 2012 to April 2015

• Assigned third and first party personal lines auto bodily injury and non-injury property damage liability claims.

• Reviewed policies / confirmed & denied coverage, investigated, contacted claimants, confirmed facts of loss; obtained

statements, arranged for vehicle inspections, reviewed submitted vehicle damage and medical invoices, diagnosis, treatments,

evaluated, set reserves, negotiated claim settlements and issued settlement drafts.

• Documented claim activity including questionable claims from beginning to end of claim; composed forms and letters, filed

EFD1 Forms as warranted.

• Adhered and complied with all DOI Regulations / Best Practices and internal claims handling guidelines / procedures

Sherman and Associates, Arenas Claims Consulting and Schneider Associates Los Angeles, CA

Investigator and Independent Adjuster February 2010 to February 2012

• Assisted various client accounts in the investigation of claims, performed task assignments, investigative research for internal agents and supporting personnel.

• Obtained P & C and workers’ compensation AOE/COE statements from insured’s / claimants, prepared and obtained reports after completion of an assignment, attended and monitored various legal proceeding including mediations, MSC, arbitrations and court.

• Assisted various private investigation firms in claims investigation and task assignments.

Workmen’s Auto Insurance Company Los Angeles, CA

Senior SIU Claims Examiner March 2009 to January 2010

Handled personal liability, multi-state auto / homeowner claims. Reviewed coverage, investigated, evaluated, set reserves, negotiated and settled third and first party claims. Reviewed assigned and transferred questionable claims, effectively managed high exposure claims, performed as technical authority in accordance with areas of specialization. Performed investigative research for internal agents and supporting personnel, claim file reviews, produced background information involving claimant / insured with regard to questionable claims, evaluated and presented recommended course of action to management.

Coordinated findings with insurance industry fraud units, claims personnel, in-house counsel, law enforcement agencies and

additional claimants / customers relevant to the investigation.

Provided evidence and testified in cases where law enforcement agencies pursued prosecution.

Handled Florida PIP claims

• Adhered and complied with all DOI Regulations / Best Practices and internal claims handling guidelines / procedures

Tokio Marine Insurance Company Pasadena, CA

Product Liability Claims Specialist (Long Tern Temporary Assignment) February 2008 to September 2008

Handled all aspects of nationwide litigated product liability claims; food poisoning, seats, tires, airbags, vehicle (rollovers) for Nissan, Isuzu, Mazda, Toyo Tire, and Yokohama. Interacted closely with office management in preparing client reports, presentations and litigation strategy.

Mercury Casualty Insurance Company Westlake Village, CA

Claims Representative (Temporary Assignment) June 2007 to September 2007

Handled to resolution third and first party standard lines auto bodily injury and property damage claims

Western General Insurance Company Calabasas, CA

Claims Supervisor August 2005 to June 2007

Responsible for the supervision of and training of adjusters / personnel

Provided written instruction in files to assist in accurate and timely claim handling by adjusters

Ensured accurate policy coverage investigations by adjusters, all total loss and total thefts were reviewed for fraud indications and all files were compliant with state laws, regulations and with Department of Insurance Regulations

Reviewed claim payments for accuracy. Handled PIP claims for the state of Florida.

Conducted weekly meetings with personnel, performed monthly phone and file audits per adjuster with follow-up counseling as needed, kept accurate personnel records of performance and attendance.

Reviewed all NICE Forewarn Alerts and worked with the internal IT department to check records for possible fraudulent activity

Utilized independent investigations in a cost effective and necessary manner.

Liberty Mutual / Prudential Property and Casualty Insurance Company Thousand Oaks, CA

Senior Claims Adjuster / Claims Adjuster July 1991 to August 2005

Handled 1st and 3rd party bodily injury and property damage claims from inception to resolution. Average caseload of 65 claim files with four or more features per file and received an average of twenty new files per week

Pending consisted of bodily injury and auto property damage claims with approximately 50% in litigation

Analyzed coverage, issued reservation of right, denial and limit letters, investigated, evaluated, set reserves, interacted with and directed defense counsel, attended mandatory settlement conferences and court trials, draft authority was $25K

Detected and performed in-depth investigation of questionable claims including field work and surveillance; evaluated and presented recommended course of actions, provided evidence and testified in cases where law enforcement agencies pursued prosecution.

Maryland Casualty Company Encino, CA

Senior Examiner August 1988 to June 1991

Adjusted 1st and 3rd party commercial auto bodily injury and property damage, general liability, product liability, E&O for brokers and umbrella police claims from inception to closure; average caseload of 85 claim files with four or more features per file; pending consisted of 25% auto bodily injury/property damage, 30% commercial auto / trucking claims, 45% general and premises liability, product liability and umbrella policies, approximately 70% litigated.

Handled, appraisals, subrogation, comprehensive and collision; attorney represented files, litigation, mandatory settlement conferences.

Crawford and Company Northridge, CA

Field Adjuster May 1986 to August 1988

Handled 3rd and 1st party commercial lines auto bodily injury and property damage, general liability, food poisoning, homeowner liability and property claims from inception to closure with approximately 20% of the pending litigated.

EDUCATION

California State University Northridge, CA

Pierce College, Woodland Hills, CA

A.A. Degree, Majored in Business Management

LICENSES

Florida Adjusters License

DESIGNATION

American Educational Institute – Fraud Claims Specialist / SIU Designation

MEMBERSHIPS

Southern California and Northern California Fraud Investigators Association

International Association of Special Investigation Units

International Association of Arson Investigators, Inc.

Awarded investigator of the year in 2000

VOLUNTEER

• Inter-Company Arbitration Forum Arbitrator

LANGUAGE

English / Spanish

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