Claims Adjuster Examiner
Resume:
MANUEL VILLARREAL
Aubrey, TX ***** • 817-***-**** • adtefe@r.postjobfree.com
INSURANCE CLAIMS EXAMINER
AREA OF EMPHASIS – INSURANCE DEFENSE
Bilingual Litigation Examiner with 20 years of experience as a Licensed Claims Adjuster and 8 years of prior experience as a Paralegal at several personal injury law firms, seeking a new opportunity within the Insurance industry. Extensive experience investigating, evaluating, and settling 1st- and 3rd-party vehicle damage, property damage, and bodily injury claims. Well-developed skills interviewing claimants and witnesses, examining policy coverage, verifying facts of losses, analyzing medical records, determining settlement ranges, negotiating settlements, submitting payment requests, and conducting trial preparation. Detail-oriented leader with outstanding communication, analytical, and negotiation skills and a proven track record of success utilizing industry expertise to consistently negotiate and settle claims at 20% under settlement range. Fluent in English and Spanish; Texas All-Lines Adjuster license and licensed in 25 other states.
AREAS OF EXPERTISE
Auto/Premises Litigation
Claims & Liability Evaluation
Medical Records Analysis
Discovery Document Review/Analysis First- & Third-Party Insurance Claims Trial Preparation Settlement Negotiations Claimant & Witness Interviewing Policy Coverage Examination PROFESSIONAL EXPERIENCE
Four Seventy Claims
September 2020-present
CAT Litigation Adjuster
● Review policy to verify coverage at time of catastrophe.
● Review pre-litigation file notes to determine whether the claim was denied, below the deductible, or partial denial.
● Confirm prior reported losses and whether repairs were completed or not to prior damage to house.
● Review engineering report paid by for company to determine cause and origin of damage to insured's house.
● Assign Suit to defense counsel with initial litigation instructions.
● Contact plaintiff attorney's office and provide them my contact information.
● Review all legal invoices, note file and request payment.
● Participate in mediation and arbitration in person or by phone.
● Files more than $150,000.00 in exposure are written up and sent to client for review and authority. ALLSTATE INSURANCE JANUARY 2019 - JUNE 2020
COMMERCIAL LITIGATION EXAMINER
● Review policy to verify whether it was active at the time of the loss.
● Confirm if the driver and the vehicle involved were on the policy at the time of the alleged accident.
● Contact the commercial policyholder and the vehicle driver to verify that our contact information is current.
● Go over the facts of loss with the driver.
● I informed each about the suit our office received to assure them we would secure them a defense attorney.
● Contact the plaintiff attorney to provide their office with my contact information.
● Review all files notes to assess where the file stood prior to suit.
● Note the action plan to conclude the file and send a copy of it to our defense attorney.
● Review all medical records and bills received post-litigation, document the file, and revise the action plan.
● Review invoices from retained counsel, document the file, and request payments.
● Participate in mediations by phone or in person.
● Files over $150,000.00 in exposure are written up and sent to Home Office for review with a conference call scheduled to discuss the file.
MANUEL VILLARREAL
Aubrey, TX 76227 • 817-***-**** • adtefe@r.postjobfree.com
● When files are settled, I call the insured and the vehicle driver to inform each that the matter has been settled SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., DALLAS, TX January 2018 – October 2018 Litigation Examiner
● Investigate and evaluate insurance coverage to reach claims decisions.
● Interview claimants and witnesses and review police reports on vehicle claims.
● Review scopes of loss on non-property damage claims and set reserves.
● Negotiate with claimants and Attorneys on all claims and follow up with inside/outside counsel on litigated files.
● Work with inside/outside counsel to discuss facts of loss, reserves, and action plans on all claims over $25K.
● Draft coverage and liability denial letters.
AGGRESSIVE INSURANCE, IRVING, TX June 2013 – October 2017 Small independent auto insurance company, servicing policies, claims, and suits for policy holders. Litigation Examiner
● Investigated 1st- and 3rd-party vehicle damage, property damage, and bodily injury claims.
● Reviewed file notes, statements from all parties, and police reports in initial evaluations of liability.
● Interviewed insureds, claimants, witnesses, Doctors, medical specialists, and/or employers to mitigate claims.
● Examined auto policies to evaluate coverage and develop settlement ranges on claims.
● Verified facts of losses with the insured parties to determine any possible coverage issues.
● Drafted and sent reservation of rights letters and maintained diaries of litigated files.
● Negotiated settlements with opposing counsel and prepared for/attended depositions, trials, and mediation.
● Submitted payment requests for property damage, rental reimbursement, or loss of use.
● Entered claim payments, reserves, and new claims into the computer system.
● Consistently settled claims for less than expected, due to personal injury knowledge and experience. IMPERIAL FIRE & CASUALTY, ADDISON, TX October 2010 – February 2012 Provides quality auto, homeowners, and flood insurance products and services at competitive prices. Bodily Injury Adjuster
● Handled bodily injury claim settlements, including investigation, evaluation, correspondence, and negotiations.
● Delivered a customer-focused claims experience while providing superior service.
● Conducted thorough coverage and liability investigations to arrive at fair and amicable settlements.
● Made decisions within delegated authority as outlined in company policies and procedures.
● Initiated and conducted follow-ups via proficient use of claims systems and related business systems.
● Opened, closed, and adjusted reserves in accordance with company practices to ensure reserve adequacy.
● Submitted reports to insurance carriers, Agents, and Underwriters.
● Assisted with or prepared files for suit, trial, or subrogation.
● Consistently settled claims at 20% below the range set by management. TARRANT COUNTY COLLEGE, Fort Worth, TX – Business Administration Coursework Paralegal Certification (2-Year)
Licenses
Adjuster: Texas, Alabama, Arkansas, Arizona, Delaware, Florida, New Hampshire, Oklahoma, Oregon, South Carolina Non-Resident Adjuster: Georgia, Wyoming, Vermont
Claims Adjuster: Louisiana
Casualty Adjuster: Connecticut
Company Adjuster: North Carolina, West Virginia
Insurance Adjuster: Arkansas, Idaho, Kentucky, Mississippi, Nevada, Rhode Island, Washington EDUCATION & LICENSURE
MANUEL VILLARREAL
Aubrey, TX 76227 • 817-***-**** • adtefe@r.postjobfree.com Non-Resident Insurance Adjuster: Indiana, Maine, Minnesota Computer Skills: Westlaw, LexisNexis, Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)
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