Description
QUALIFICATIONS I have been both Inside desk Adjusting/ File Reviewing (desk adjuster) and investigating insurance losses and Examining claims (CAT, daily & fraud-related) for app. 17 years and have a broad exposure to catastrophe & disputed losses (litigation also). I am BI-Lingual GA, have my passport, and licensed as a 2-15, 5-20 and 4-40 & General Commercial Adjuster (Citizens). Also licensed as an adjuster in app 20 states. I am Hazwoper 40, Sinkhole, Litigation (MCM), CAE Earthquake, Flood, & Commercially Certified. I am a graduate of NYU with BS in Accounting & St. John's University (MBA) In 2012, I became a "wind mitigation inspector" for Citizens via Inspection Depot. Over the years, I have worked claims both in the field and in-house. I have handled many types of property claims including Residential, Mobile Home, Commercial, and Farm/Ranch, & Bodily Injury& Environmental & auto claims. Types of perils include wind/hail, ice & snow, tornado, fire, asbestos, sinkholes, hurricanes, & PI. I have also processed many daily losses such as drain overflows, pipe leaks, and fires. I have performed SIU investigations and Federal Investigations for app. 7 years. I was one of the top 2 Fraud Investigators in the Internal Revenue Service. I contribute to writing their Fraud manuals, as a Special Enforcement Agent GS-13), and earned the HQI award. Recent 1099 Inside Desk adjuster deployments: For example: From 04/26/2017-present-Desk adjuster for Eberl for ASI (American Strategic Insurance) in St. Petersburg, Florida. Documented initial contact, Policy/Coverage review, opened or adjusted Reserves, Cat file damages reviewed & approved or collaborated in Xactanalysis, prepared Statement of Loss & Payment authorizations and Final payment letters (partial or full declinations, below deductibles, no damage) closing of claim letters. From 01/14/2017 - 4/03/2017 -GA-commercial claims desk adjuster for Bradley Stinson Claims for Citizens Property Insurance in Jacksonville, Fl. Demonstrated knowledge of Citizens best claims practices and CHI (Claims Handling Instructions) to resolve moderate to high priority wind, fire, asbestos and other Hurricane Matthew commercial property claims. Knowledge of all lines of property/casualty insurance. Ability to operate their Claim Center claims systems and related software (Guidewire & Xactimate). Skills/Competencies: Proven ability to meet customer needs and provide exemplary service by informing customers of the commercial claims process and ensuring a positive customer experience. Analytical skills necessary to make decisions and resolve conflict in such areas as application of coverage to submitted claims, application of laws of jurisdiction to investigation facts, application of policy exclusions and exceptions. Ability to successfully negotiate commercial property claims of moderate to serious nature ( Condos and Buildings with over 1 million dollar damages). Command of written and verbal communication skills for contact and/or negotiation. Organizational skills to effectively establish work priorities in accordance with Citizens Best Claims Practices and use of CHI. Ability to operate a PC and related software (Xactimate) for Citizens. From 10/11/2016 to 12/31/2016 -desk adjuster for Team One handling Hurricane Matthew claims for Frontline Insurance in Lake Mary, Florida (authority $50,000). Review of FNOL to document diary to review photos and FA reports to prepare estimates and check requests, payment letters, pay claims from $30,000 to $250,000 then contact Ni to explain FA report and final payments. Cat Manager-Ben Beuttner and Operation Director Iasha Pryor From 8/13/2016 to 10/10/2016 desk adjuster for IMS Claims, Inc. handling flood claims out of Louisiana for Gulfstream & St John's Insurance and Hurricane Hermaine claims in Florida, Louisiana, Alabama, Mississippi and South Carolina also for Gulfstream Insurance via TPA Seibels Technology and Solutions Experienced in CPX (claim processing expert ) Review all COL files determined coverage analysis, endorsements and all exclusions reviewed IA Final Report damages attach IA invoices, Discussed estimates and payments or denials with NI Documented activity log and diary then prepared below deductible letters, full or partial denial letters Payment letters. $50,000 check approval Also negotiated $100,000 to $250,000 large losses. Handled large loss litigation/settlements as well for IMS Catastrophe Services at Seibels Technology and Insurance Services Cat Manager Rodney Harrision From 01/15/2015 to 02/28/2016 handled auto liability claims for State Farm via CNC Resource -everything from new claims, new mail, default calendar, file notes, claim reassignments and more including payments. From 01/14 to 12/14 handled "Liability and litigation" claims for Team One 03/12 to 12/12-Wind Mitigation Inspector for Citizens From 01/12 to 03/12 worked as desk adjuster and handled sinkhole claims for as inside desk adjuster for Bradley Stinson for Citizens (but withdrew due to conflict of interest since my home wound up with a sinkhole) From 06/2013 thru 12/2013-Cat Sandy & Andrea claims From 10/2012 thru 12/2012 (Cat Sandy) and Feb 2011 thru Dec 2011 (Cat Irene) worked for Kemper Insurance in Charlotte, N.C. as "Desk Adjuster" and periodically as a Lead via ICA CAT Managers Brad Hunter and Brian Jonas I Multi-tasked every phase of the claim from first contact, setting up diary to contacting the FA's and assigning files. Reviewing FA photos & investigating the claim. General loss reports and final estimates for consideration of payment and/or collaboration in Xactimate 27.3 & recently 28 while withholding Rec Dep (recoverable depreciation). Responsible for ensuring all Kemper customer risks were "Insured to Value (ITV)" using Xactimate 360V. In an effort to improve risk management, Completed ISO reports on ALL Risks and forwarded to underwriting when risks not ITV. Awaiting of Rec Dep docs for payment of Rec Dep being held by insurer and subsequent closing claims. Responsible for Issuance of checks and stop payments, as well. Prepared disclaimers & handled subrogation issues also. Analyzed "fraud aspects" of claims. Trained new IA's in Kemper procedures and guidelines. From April 2010 to December 2010, Worley Catastrophe Response (Hammond, La.) assigned to British Petroleum (BP) initially in there ICU unit for Shane Heath and Brad Capps, Managers. I handled mostly large loss or claims, environmental and bodily injury claims for BP in Hammond, La. under Catastrophe Manager Don Cannon. I subsequently worked environmental claims determining compensability and final adjustments in their GCU and Large Loss unit for Brad Capps and Don Cannon. In addition, I acted as an on-call "consultant" (reviewing validity of tax & other documents presented by claimants) to the outside Accounting firm hired by BP and Mr. Feinberg while also working for Jeff DE Benedetto (Worley's SIU Manager.) while still performing both Large Loss & "SIU/SHU internal fraud investigations" as an investigator. I worked in the Large Loss Unit as Senior Adjuster for Russell Shaw specializing in Real Estate Division. Before entering the adjusting field, I worked with contractors building new homes. My responsibilities included overseeing framing, siding and shingling new homes, performed repairs, and completed interior build-outs. I have also spent time supervising reconstruction of storm damage from Hurricanes and Tornados. I am a licensed Wind Mitigation Inspector thru Inspection Depot, as well. I am also a licensed Real Estate Broker in the State of Florida since 1989. This hands on experience has given me the ability to quickly identify damages, discuss losses with comprehension, and follow through with accurate reports. I have been utilizing Xactimate as my primary estimating platform since 2001 and am currently using Xactimate. I am proficient Simsol and other estimating versions also. I am proficient at setting preferences to meet specific carrier mandates, producing detailed diagrams of roofs and interiors, and requesting and uploading reports. I am capable of providing accurate reports while working with contractors and insured's to reach equitable settlements. In claims, customer service is key to success. Over the years of working as a property claims adjuster, it has been important to provide excellent service to insured's. I have always approached claims with the understanding that the insured and I have a common goal, the quick and proper settlement of their claim. I have gained excellent communication skills, verbally & in writing, via litigating /disputed claims.
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