Senior Claims Compensation

VICKIE L. BELL

***** **** ******, *********, ** *0250

*******@*****.***; 310-***-****

PROFESSIONAL SUMMARY

** *****’ experience in Worker’s Compensation Claims.

Experienced in Carrier, TPA environment.

Managed high exposure & complex files, up to $2,000,000 plus in reserves.

Effectively managed heavy caseloads, 95% litigated and average pending of 175 + files.

Investigation of new claims & caseload management.

Conduct file reviews for brokers, clients and risk managers.

Well versed in case law and Labor Code.

Prepared cases for Expedited Hearings, Mandatory Settlement Conferences and Pretrial Conferences, Status Conferences for the defense.

Permanent disability rating (Old and New).

Knowledge of SB899 and SB863 changes and MPN requirements.

Negotiate and settle claims, prepare settlement papers.

PROFESSIONAL EXPERIENCE

CHUBB & SONS, Los Angeles, CA January 2015 – Present

Claims Director

Produce a high-quality work product on intermediate to complex claims through immediate contact and the effective investigation, reserving and adjustment of claims incurred by clients or third parties.

Analyze first report to determine nature of loss, coverage provided, compensability and scope of injury/damage.

Conduct investigations of all aspects of reported claims.

Establish accurate and timely reserves.

Promptly and properly, document all developments in claim file.

Exercise good judgment in reaching final disposition of claim by evaluating nature of loss, liability, injury/damage, and coverage provided and applicable limits.

Effectively negotiate compromise settlements where appropriate.

Recognize and pursue subrogation and contribution where applicable.

Familiar with multi-jurisdictional laws and regulations.

TOKIO MARINE, Pasadena, CA March 2014 – December 2014

Senior Claims examiner

Managed claims from inception through investigation, determination of compensability and payment of benefits.

Prepared claim analysis for settlement and status reports for claims reviews.

AIG/CHARTIS DOMESTIC CLAIMS, Santa Ana, CA May 2007 – March 2014

Senior Claims Representative

Administered a mix of challenging new files and extremely challenging, high exposure old files.

Remedied an assigned substandard caseload of 185 cases with corrective actions and achieved numerous settlement and closure outcomes.

Proactively managed the caseload including preparation of pleadings and applications to the WCAB, and pursued subrogation recovery in numerous cases.

Improved client satisfaction through customer service and claim reviews.

MAJESTIC INSURANCE, Long Beach, CA July 2004 – April 2007

Senior Claims Examiner

Responsible in handling workers’ compensation claim from start to finish.

This included investigation, medical management, litigation, case resolution.

Direct contact with employers, medical professionals and attorneys, in addition to any other vendors.

Estimate case closure 90% of cases within six months.

KEENAN & ASSOCIATES, Torrance, CA January 1997 – February 2004 Senior Claims Examiner

Conducted prompt and thorough investigations, evaluate facts, interpreted laws and regulations, and render determinations, including compensability and medical determinations.

Consulted with brokers, doctors, employers, and lawyers in the evaluation of a claim. Continuously analyze case facts and monitor activities to identify fraud and/or abuse, and/or third-party liability throughout the course of the claim.

Reviewed photographs and written or audio-taped or video-taped statements.

Considered the relative costs and benefits of potential actions to choose the most appropriate one.

Managed legal issues that can be managed without the use of a defense attorney.

Negotiated with the claimant or applicant attorney to settle the claim.

EDUCATION AND CREDENTIALS

Bachelor of Business Administration Management, Magna Cum Laude, 2006

American InterContinental University, Hoffman Estates, Illinois

Associate of Arts Business Administration, 2005

American InterContinental University, Hoffman Estates, Illinois

Industry Certification -Insurance Education Association, 1997-2002

Workers’ Compensation Claims Administration, (WCCA)

Workers’ Compensation Claims Professional (WCCP)

Self-Insured Administrator Certificate (SIP)

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