Cynthia Fortune
Conyers,GA
Summary
Proven expertise in claims analysis and critical thinking, honed at Progressive Insurance, where I streamlined claim management processes and effectively negotiated settlements. Complex claims adjurer with extensive property and casualty claim experience. currently licensed in multiple states. I possess the ability to maintain inventory accurately and efficiently through file management, time management and prioritization. Seeking a complex opportunity to enhance current skills while securing new skills to advance into leadership.
Overview
7
7
years of professional experience
Work History
Commercial Claims Generalist Sr.
Progressive Insurance
08.2022 - Current
- Organize detailed records for each claim, enabling quick retrieval of information when needed.
- Negotiate fair settlement amounts with claimants and insureds, minimizing company losses while satisfying client needs.
- Manage a caseload of diverse insurance claims, ensuring timely and thorough investigations.
- Present findings from complex investigations at internal meetings, contributing valuable insights to ongoing improvement efforts within the department.
- Prepare detailed coverage analysis and recommendations on denying coverage
- Streamline inventory management by implementing efficient time management and prioritization
- Actively engage in all phases of litigation providing analysis of each phase to include, initial litigation, written and oral discovery, mediation and trial.
- Actively participate in mediations in an effort to move towards resolution
- Assess risk at every opportunity to identify opportunities to resolve
- Actively participate in team meetings designed to identify areas of improvement, strengths and challenges
- Proactively negotiate settlements to resolve claims
- Partnered with both in house and external defense counsel on litigation files.
Bodily Injury Claims Specialist
State Farm Insurance
06.2017 - 07.2022
- Assisted in the development of new policies or procedures that helped improve overall team efficiency in managing bodily injury claims portfolios.
- Ensured compliance with state regulations during every stage of the claims process, minimizing risk for both the company and policyholders.
- Achieved successful claim resolutions by thoroughly investigating and evaluating bodily injury claims.
- Conducted timely negotiations with claimants'' representatives to reach fair settlements within policy limits.
- Conducted full, claim investigations, obtain recorded statements, and report updates and legal actions.
- Reviewed, analyzed, and referred suspicious and
potentially fraudulent insurance claims to SIU. - Examined applicable coverage to extend or deny coverage. Documented files according to company and DOI standards.
- Escalated files with significant indemnity exposure to management for direction and/or authority.
- Followed up with customers on unresolved Issues.
- Reviewed and prepared pre-trial and mediation reports with the assistance of defense counsel
- Actively participated in court ordered mediations to resolve case pre-trial.
- Partnered with both in house and external defense counsel on litigation files.
Education
No Degree - Business Administration
Saint Francis College
Brooklyn, NYGED -
Brooklyn College Acadeny
Brooklyn, NY09.1995
Skills
- Claims Investigation
- Claims analysis
- Policy Interpretation
- Claims Auditing
- Coverage assessments
- Settlement determinations
- Accident investigations
- Medical terminology
- Regulatory knowledge
- Critical Thinking
- Litigation Handling
- Microsoft Office
- Legal Exchange
- RUMBA
Timeline
Commercial Claims Generalist Sr.
Progressive Insurance
08.2022 - Current
Bodily Injury Claims Specialist
State Farm Insurance
06.2017 - 07.2022
No Degree - Business Administration
Saint Francis College
GED -
Brooklyn College Acadeny
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