Customer Service Claims Representative

Commercial Property General Liability Auto Worker’s Compensation Military Subrogation

Arbitration Coverage Investigations Policy Interpretation Mediation Litigation

HERITAGE PROPERTY & CASUALTY INSURANCE COMPANY, Tampa, FL

Litigation Examiner – Property Present

Handles 1st party litigated property claims associated with Hurricane Irma

Directs Defense Counsel throughout the litigation process in accordance with client objectives

Ensures a Response is filed timely and Case Management Order is adhered to

Coordinates and attends all Pre-Trial Conference Calls, Meditations and Arbitrations

Ensures all AOB Matters are responded to and considered during settlement

Identifies and ensures all CRNs are responded to timely

Ensures Proposal for Settlements are filed timely and appropriately

Reviews all pre-suit activity on the file and identifies any potential weaknesses

Establishes reserves, defense council’s budget, and documents rationale accordingly

CLAIMS QUESTIONS, Tampa, FL

Litigation Specialist – Property 2021

Handled 1st party litigated property claims of high severity & complexity

Interpreted court dockets and communicated with Client Management, Client Legal & Opposing Counsel

Responded to decisions, agreements, and/or court order and creates action plans

Responsible for coverage analysis and investigation

Effectively negotiated settlements by working with Defense Council

Evaluated claims based on coverage, liability, causation, and damages according to state laws

Presented claim/lawsuit to the Insurance Carrier monthly, or on an “as needed” basis

ICAT, Broomfield, Colorado

Commercial Claims Examiner II - Property 2018 - 2021

Adjusted Commercial Property and Catastrophe claims for multiple carriers

Negotiated with insureds, public adjusters, attorneys and other third parties representing the insured

Prepared reports based on field adjuster reports and expert findings

Identified risk policies and alerts underwriting

Prepared appropriate Declination and Reservation of Rights Letters

Worked with agents and brokers to ensure efficient claims handling and excellent customer service

Provided direction and oversight to Defense Attorneys to ensure litigated files were resolved maintained and monitored expenses

ASI, St. Petersburg, Florida

Independent Adjuster – Property 2017 - 2018

Performed coverage analysis, damage evaluations, negotiated settlement, denials, recovery and SUI referrals for catastrophe claims resulting from Hurricane Harvey and Hurricane Irma.

Collaborated estimates with homeowners and contractors to address additional damages not included in the field adjuster report.

Coordinated and managed field investigations, outside engineers, contractors, and cause and origin experts.

Worked with and negotiated with various vendors to mitigate damages and oversee repairs.

Selected as member of the Supplement Team and assigned Large Loss files.

Worked in Xactimate and XactAnalysis

STATE FARM INSURANCE, Englewood, Colorado

Independent Auto Adjuster – Auto Bodily Injury 2015 – 2017

Evaluated, negotiated, and adjusted complex auto bodily injury claims.

Determined policy coverage for submitted claims and notified the insured of any issues.

Determined and established reserve requirements.

Monitored Medicare compliance, reporting, and protected Medicare Liens in resolution of all claims involving Medicare Recipients.

Identified and referred suspect files to the Special Investigation Unit.

SEDGWICK CMS, Lewisville, Texas and Greenwood Village, Colorado

Claims Representative – Professional Liability 2011- 2015

Investigated and processed first and third-party general, automotive, professional liability and property claims for multiple clients.

Assigned onsite scene investigation, notified defense counsel, and client of accidents involving serious bodily injury.

Established and maintained reserves up to $250,000 based on known facts, estimated damages, reported injuries, current investigation, and potential exposure to the client.

Submitted and responded to Property Arbitration Forum. Prepared supporting documentation, expert reports, briefs of law, photographs, statements, etc.

Supported client in subrogation process by either referring file to internal subrogation team or pursued subrogation directly for client.

Claims Representative – Worker’s Compensation

Analyzed and processed claims lost-time and medical-only workers compensation claims.

Processed workers compensation claims determining compensability and benefits due on long term indemnity claims, monitored reserve accuracy and files necessary documentation with state agency.

Processed assigned disability claims and determined benefits due pursuant to the disability plan or client contract.

HALLMARK, Plano, Texas 2010-2011 Property & Casualty Adjuster

Investigated and handled to conclusion first and third-party claims involving coverage and liability determination.

Conducted investigations to determine coverage for claims of minor to moderate complexity where Bodily Injury settlements were needed.

Established timely and accurate claim and expense reserves.

Negotiated and conveyed claim settlements within authority limits.

ESURANCE, Addison, Texas 2008-2010

Claims Representative 1

Investigated and handled to conclusion first and third-party claims involving coverage and liability determination.

Reviewed, evaluated, and negotiated first call injury claims requiring minimal treatment up to $1,500.

Properly documented files to include all key activities, contacts made, statements taken, including a full outline covering all aspects of the claim and what is needed for resolution.

VITAMIN SHOPPE INDUSTRIES, INC., Lewisville, Texas 2005-2008

Store Manager

Sales Management: Managed daily sales and customer service operations for a high-volume specialty retail store grossing $1 million annually. Planned and coordinated sales and marketing programs to increase market share and profitability.

Financial Operations: Managed daily financial operations, including cash handling, sales analysis, sales reporting, payroll, and inventory control. Prepared and delivered bank deposits.

Training/Staff Development: Recruited, interviewed, hired, trained, supervised, scheduled, and evaluated performance of 8-10 employees, including two Assistant Managers and 7-8 sales associates. Provided ongoing sales training to staff in customer service, sales processes, and product knowledge to support consistent achievement of company goals for service and profitability.

Inventory Control: Monitored and tracked inventory to ensure accurate and timely accounting records. Conducted periodic cycle counts. Coordinated physical inventory with REGIS inventory control service.

UNITED STATES AIR FORCE, United States 1997-2001

Security Forces Member

Emergency Services Team: Provided security to protect the President of the United States, government/military officials, and distinguished visitors. Trained in conducting risk assessments of physical structures, environmental conditions, and potential hazards to ensure protection of government personnel, property, and assets. Trained in anti-hijack operations, anti-terrorist missions, and counter-sniper operations. Trained with officers from local police departments, sheriffs' departments, correctional facilities, FBI, and the U.S. Marshals Service.

Security Clearance: Secret. Honorable Discharge.

Security Services: Provided security services to military installations to ensure protection of personnel and resources. Assigned to a major NATO installation in Aviano, Italy for two years. Protected base personnel and assets during Operation Allied Force which provided assistance to the citizens of Kosovo. Coordinated security services with foreign military security agencies from Canada, Italy, Germany, Spain, and Great Britain.

Training/Staff Development: Trained new flight personnel in operational and security procedures required to protect resources vital to national security of the United States.

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