Abdul-Karim Muhammad
Houston,Texas
Summary
Establish facts of loss, Investigate and maintain property/casualty claims, Determine liability,
secure information, review coverages, arrange appraisals, and settle, Knowledge and
understanding of total loss, appraisal, litigation and settlement process. Settlement
negotiations, fraud detection, and effective utilization of authorized vendors, Investigator
dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex
problems. Proven history of leveraging excellent negotiation skills to facilitate
settlements. Excellent communication skills demonstrated through eight years of
experience interviewing specialists, witnesses, and claimants to compile information. Excellent abilities to decipher fraudulent activities, analyze data, confer with legal counsel and communicate with agents, vendors, and brokers to gain details for processing claims, Insurance Adjuster skilled in investigating and analyzing liability concerning personal, casualty or property loss.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Insurance Claims Adjuster
Best Claims Solutions
08.2023 - 01.2025
- Write estimates for damages using Xactimate and Xact Contents
- Promptly investigate facts of loss, coverage, liability and damages on losses.
Accurately document all investigative activity and secure appropriate claim
documentation.
- Develop and maintain file summaries and action plans from the point of assignment and
throughout the claim life.
- Develop investigative plans to include resolution of coverage issues, as required.
- Audit reviews on new claims, claim payments, claim handling, reserves and make
corrections, as needed. - Negotiate settlement of claims with customers, claimants, and vendors.
- Discuss claim statuses and give updates to customers, claimants, agents, and leadership
throughout the process. - Responsible for compliance with state insurance regulations and company claim handling
guidelines, and all other assigned duties. - Improved claim resolution times by efficiently managing a caseload of 50+ claims per
month. - Achieved cost savings through successful subrogation efforts, recovering funds from
responsible parties in various claims scenarios. - Streamlined internal processes by implementing new claims management software,
increasing overall productivity. - Reduced processing time for property damage claims by accurately assessing repair costs
and negotiating with contractors. - Maintained compliance with state regulatory requirements through meticulous
documentation and adherence to company policies.
Insurance Claims Adjuster
Allied American
10.2022 - 06.2023
- Identify potential fraud indicators early in the investigation process, protecting company
assets from potential losses due to fraudulent activity. - Recognize and review claims requiring specialized handling, including identifying issues
that may require use of independent experts or vendors. - Conduct analysis of new claim assignments and develop investigative plans based on
need of the claim. - Provide exceptional customer service during emotionally difficult situations for
policyholders following accidents or natural disasters.
Improve claim resolution times by efficiently managing a caseload of 150+ claims per
month. - Apply knowledge of policies, procedures, laws, statutes and insurance regulations when
determining coverage, liability, damages of injury, and property damage. - Investigate high volume complex claims across multiple jurisdictions.
- Evaluate negotiate and settle claims in to include verification of coverage, legal liability,
and extent of damage to persons and property.
Insurance Claims Adjuster
Best Claims Solutions
09.2021 - 01.2022
- Interpreted and explained policy regulations, exclusions and coverage
- Interviewed and corresponded with claimants, witnesses, medical bills and physical property to determine the extent of liability.
- Assisted team members in resolving challenging cases using expert-level problem-solving
skills and attention to detail. - Enhanced claim resolution speed by efficiently investigating and assessing damages in the
field. - Maintained a strong understanding of policy coverages and applied this knowledge to
accurately assess claim eligibility. - Collaborated with other adjusters, contractors, and engineers to ensure accurate
evaluations of complex claims situations. - Achieved high levels of customer satisfaction by consistently meeting or exceeding
expectations in claim handling and resolution. - Successfully managed a high volume of claims, phone calls and paperwork
- Efficiently managed a high volume of daily claims without compromising quality or
customer service standards. - Upheld legal compliance standards through meticulous reporting and documentation of
claims processes.
Insurance Claims Adjuster
Best Claims Solutions
05.2021 - 09.2021
- Made prompt contact with customers to set expectations, develop action plans, and
perform initial exposure assessments. - Successfully managed a high volume of claims, phone calls and paperwork
- Interpreted and explained policy regulations, exclusions and coverage
- Interviewed and corresponded with claimants, witnesses, and physical property to determine the extent of liability
- Verified data to ensure validity of claims.
- Performed damage and loss assessments related to flood events and determined record
level of damage based on the evaluation of dwelling, personal property and furnishings. - Prepared estimates and settlements according to company specifications and inspection
guidelines. - Explained coverage to policyholders providing excellent customer service.
- Interviewed insureds and reviewed factual information to prepare damage estimates.
- Evaluated and made recommendations regarding coverage of claims, determined liability
for claims, and negotiate settlements within designated limits. - Determined and negotiated settlement amounts for damages claimed within assigned
authority limits. - Maintained a strong understanding of policy coverages and applied this knowledge to
accurately assess claim eligibility. - Ensured regular and timely follow-up and bring claims to prompt and appropriate
conclusions while keeping the customer informed throughout the life cycle of the claim process. - Assisted team members in resolving challenging cases using expert-level problem-solving
skills and attention to detail. - Enhanced claim resolution speed by efficiently investigating and assessing damages in the
field. - Collaborated with other adjusters, contractors, and engineers to ensure accurate
evaluations of complex claims situations. - Achieved high levels of customer satisfaction by consistently meeting or exceeding
expectations in claim handling and resolution. - Efficiently managed a high volume of daily claims without compromising quality or
customer service standards. - Upheld legal compliance standards through meticulous reporting and documentation of
claims processes.
Education
The Adjuster School
Houston, United States07.2021
High School Diploma -
Elevated Places
06.2021
Skills
- Policy Interpretation
- Data Analysis
- Claims Investigation
- Property valuation
- Coverage and Damage
Assessment - Liability Determination
- Claims Processing
- Policy investigations
- Caseload Management
- Settlement Negotiation
- Fraudulent Claims
Investigation
Certification
- State Farm: Property, Policy, Estimatics, Auto Claim
- California Fair Claim Settlement Practices
- NICTA
- NFIP
- TX
- AZ
- CA
- CT
- FL
- MT
- NV
- OR
- SC
- UT
- WV
- IL
- MN
- WA
- VT
- OK
- NC
- ID
Timeline
Insurance Claims Adjuster
Best Claims Solutions
08.2023 - 01.2025
Insurance Claims Adjuster
Allied American
10.2022 - 06.2023
Insurance Claims Adjuster
Best Claims Solutions
09.2021 - 01.2022
Insurance Claims Adjuster
Best Claims Solutions
05.2021 - 09.2021
The Adjuster School
High School Diploma -
Elevated Places
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