Ciera Watson
Lakeland,FL
Summary
Claims Adjuster with over 10 years experience with assessing and processing various types of claims efficiently. Superbly positioned to investigate, evaluate and settle liability, bodily injury, personal injury medical claims, and property and casualty insurance claims. Excellent abilities to decipher fraudulent activities, analyze data, confer with legal counsel and communicate with insurance brokers to gain details for processing claims.
Utilizes analytical and negotiation skills to reach fair settlements and maintain compliance with policies. Knowledge of regulatory standards and exceptional customer service, ensuring fair and timely resolutions.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Claims Adjuster
All Cat Claims Solutions
08.2024 - 02.2026
- Entered claim payments, reserves and new claims on computer system, input concise yet sufficient file documentation.
- Investigated, evaluated and settled claims, applying technical knowledge and human relations skills to achieve fair and prompt disposal of cases and to contribute to reduced loss ratio.
- Analyzed police reports, medical treatment records, and bills to assess liability extent.
- Corresponded with claimants, witnesses, police and physicians to determine claim settlement, denial, or review status.
- Resolved complex, severe exposure claims, using high service oriented file handling.
- Participated in discussion at claim committee meetings.
- Examined claims forms and other records to determine insurance coverage.
- Referred questionable claims to investigator and claims adjuster for investigation and settlement.
- Adjusted reserves and provided reserve recommendations to ensure that reserve activities were consistent with corporate policies.
- Analyzed information gathered by investigation and report findings and recommendations.
- Conferred with legal counsel on claims requiring litigation.
- Interviewed or corresponded with agents and claimants to correct errors or omissions and to investigate questionable claims.
- Investigated and assessed damage to property and created and reviewed property damage estimates.
- Verified and analyzed data used in settling claims to validate claims and settlements according to company practices and procedures.
- Attended mediation or trials for claims and investigations.
- Assist in taking new loss reports and handling of general liability first party claims.
- Document file and prepare for summaries.
- Determine liability/ no fault or at fault claims
- Answer attorney demands and prepare for suit related claim.
- Assist with mentoring and guiding team members that need help with coaching and diary work.
- Take recorded statements.
- Resolve and close on average 100+ claims per month.
- Work closely and prepare for litigation, mediation, or arbitration with legal counsel.
- Analyzed claims to determine validity and assess coverage under applicable policies.
- Reviewed documentation and evidence to support claim decisions and ensure compliance with regulations.
Automobile, Liability & Bodily Injury
State Farm
Lakeland, FL
01.2023 - 04.2024
- Clearly documents thought process, investigation, evaluation, negotiation, and settlement decisions.
- Provides advice and sets expectations into next steps to members.
- Collaborates and supports team members to resolve issues and identify appropriate matters for escalation.
- Partners and/or directs vendors and internal business partners to facilitate timely claims resolution.
- Supports workload surges and/or Catastrophe Operations as needed.
- Provided elevated customer experience to generate loyal clientele.
- Examined claims investigated by insurance adjusters, further investigating questionable claims to determine whether authorized payments.
- Paid and processed claims within designated authority level.
Independent Desk Adjuster, Homeowners
Alacrity Solutions
FL
06.2022 - 01.2023
- Analyze and interpret renters & homeowners insurance policies
- Scope damage to create and estimate utilizing Xactimate software
- Negotiate settlement of claims with policy holders, contractors, and agents
- Dictate and create settlement letters regarding coverage and non-coverage
- Worked in a call center environment handling calls from policy holders, contractors, and agents
- Negotiate and handle supplement documents and files
- Examined claim forms and other records to determine insurance coverage
- Verified Insurance claims using ISO and determined fair amounts for settlement
- Investigated and assessed damage to property and reviewed property damage estimates.
PIP Claims Adjuster
Geico
Lakeland, FL
06.2016 - 06.2022
- Evaluate and investigate policy coverage, liability and damages, and bodily injury in a timely manner following a set of general claims and statutory guidelines.
- Established at fault percentage determining the liability of both claimant and insured.
- Identifies and handles existing and emerging risks that stem from business activities and the job role.
- Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled.
- Follows written risk and compliance policies, standards, and procedures for business activities.
- Adjusts non-attorney involved soft tissue bodily injury claims, as well as all auto physical damage associated with those claims.
- Adjusts soft tissue, moderately complex and complex 1st party PIP/MP medical claims.
- Identifies, confirms, and makes coverage decisions on soft tissue claims.
- Investigates loss details, determines legal liability, evaluates, negotiates, and arrives at claim settlement within appropriate authority guidelines.
Education
GED -
Alternative Unlimited Adult School
Bartow, FL09.2014
Skills
- Strong Client Relations
- Creative Problem Solver
- Quick Learner
- Insurance Policy Knowledge
- Determination and Will to Succeed
- Claims investigation
- Caseload management
- Policy investigations
- Risk management
Certification
- AIE - Accredited Insurance Examiner
- Licensed Florida Insurance Adjuster - ALL Lines 0620
- 215 License for FL, TX, OH, VA, GA, SC, MI, TN
- Xactimate Experienced
- ISO Experienced
Timeline
Claims Adjuster
All Cat Claims Solutions
08.2024 - 02.2026
Automobile, Liability & Bodily Injury
State Farm
01.2023 - 04.2024
Independent Desk Adjuster, Homeowners
Alacrity Solutions
06.2022 - 01.2023
PIP Claims Adjuster
Geico
06.2016 - 06.2022
GED -
Alternative Unlimited Adult School