David Robinson
Round Rock,TX
Summary
Result-oriented professional with expertise in all facets of claims processing dedicated to optimizing customers’ experience while meeting business goals and financial objectives. Skilled in collaborating with insurance representative, clients, and legal professionals in the evaluation, processing, and settlement of auto, property, and medical claims. Collect and analyze supporting documentation to verify authenticity and identify suspicious activity. Prepare evidence and documentation for mediations and court hearings.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Claims Adjuster
Gallagher Bassett
2023.02 - Current
- Investigate, evaluate, and resolve complex general liability and auto claims, applying your claims experience and analytical skills to make informed decisions and bring claims to resolution
- High severity in the $100k-$15 million range
- Work in partnership with our clients to deliver innovative solutions and enhance the claims management process
- Think critically, solve problems, plan, and prioritize activities to optimally serve clients
Claims Adjuster
CPR Insurance Group
2021.12 - 2023.02
- Obtained and reviewed required documentation including first reports of loss and supplementary information to evaluate injury claims and identify suspect activity
- Personal and Commercial policies
- Processed and closed claims and completed estimates in strict adherence with company and insurance client guidelines and regulatory requirements
- Reviewed relevant records including police reports and medical treatment histories to verify liability and advise on claim processing strategies
- Negotiate final settlements in collaboration with injured parties and legal representatives
- Collected, analyzed, and documented evidence in support of court proceedings
Claims Adjuster
Zurich IPS
2021.09 - 2021.12
- Investigate, evaluate and adjust commercial claims in accordance with established claim handling standards and laws
- Establish reserves and/or provide reserve recommendations within established reserve authority levels
- Review, approve or provide oversight of medical, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims
- Negotiate any disputed bills or invoices for resolution
- Authorize and make payments of commercial claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority
- Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate
Litigation Consultant
Sedgwick
2021.01 - 2021.09
- Work on Amazon corporate account with BI exposures up $10 million
- Prepare large loss notices and recommendations on value and reserves
- Work with defense attorneys on strategy, attend mediations virtually
- Working inventory around 225 claims
Senior Claim Consultant
CCMSI
2020.07 - 2021.01
- Investigate, evaluate and adjust multi-line claims in accordance with established claim handling standards and laws
- Establish reserves and/or provide reserve recommendations within established reserve authority levels
- Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims
- Negotiate any disputed bills or invoices for resolution
- Authorize and make payments of multi-line claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority
- Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate
- Assist in the selection, referral and supervision of designated multi-line claim files sent to outside vendors
- (i.e
- Legal, surveillance, case management, etc.)
Claims Adjuster
Hammerman Gainer
2020.03 - 2021.01
- Obtained and reviewed required documentation including first reports of loss and supplementary information to evaluate injury claims and identify suspect activity
- Personal and Commercial policies
- Processed and closed claims and completed estimates in strict adherence with company and insurance client guidelines and regulatory requirements
- Reviewed relevant records including police reports and medical treatment histories to verify liability and advise on claim processing strategies
- Negotiate final settlements in collaboration with injured parties and legal representatives
- Collected, analyzed, and documented evidence in support of court proceedings
Transportation Adjuster
The Littleton Group
2019.04 - 2020.07
- Review and determine coverage for first party tractor claims
- Prepare reports to clients for authority
Senior Claims Examiner
CRAWFORD & COMPANY
2016.01 - 2019.04
- Obtained and reviewed required documentation including first reports of loss and supplementary information to evaluate injury claims and identify suspect activity
- Personal and Commercial policies
- Processed and closed claims and completed estimates in strict adherence with company and insurance client guidelines and regulatory requirements
- Reviewed relevant records including police reports and medical treatment histories to verify liability and advise on claim processing strategies
- Negotiate final settlements in collaboration with injured parties and legal representatives
- Collected, analyzed, and documented evidence in support of court proceedings
Claims Specialist
STATE AUTO FINANCIAL CORPORATION
2012.02 - 2015.11
- Acted as intermediary between insurance companies and customers, including researching and assessing information to determine validity of claims
- Auto, commercial general liability, product liability, construction defect
- Collaborated with clients to facilitate the claims process and collect required documentation resulting in increased customer satisfaction and retention
- Reviewed and verified medical claims to ensure regulatory compliance
- Analyzed claims to identify suspicious activity and report to Special investigation unit for investigation
- Cultivated and maintained business relationships with insurance representatives, car dealers, and loan processors to achieve business goals and financial objectives while meeting clients’ needs
- Collaborated with 3rd part vendors to coordinate a variety of services including emergency repairs, cleaning services, and contractors to optimize clients’ claim process experience
- Created comprehensive litigation strategies for 50 cases in accordance with local, state, and federal laws
- Participated in court mediations assisting in the achievement of an 80% settlement rate
Senior Claims Specialist
BRIGHTCLAIM, INC.
2008.01 - 2012.01
- Reviewed property and casualty insurance policies to determine coverage and facilitate decisions to approve or deny claims
- Worked with potential customers to assess coverage needs and design policies
- Spoke with policy holders to explain coverage and assist with completing paperwork required for claims including properly itemizing damages and loss
- Coordinated alternate living arrangements
- Drafted monthly reports of claims approved, denied, and in-progress as well as new policy information for management review to assist in creating strategic business initiatives to meet company goals and financial objectives
- Pursued continuing education and training programs to continue professional development Advanced Casualty courses, monthly continuing education classes
Casualty Claim Manager
Southern United Fire Insurance
2006.01 - 2008.01
- Promoted after highly successful tenure to manage five adjusters and an assistant in assessing and processing claims in accordance with company policies and procedures while ensuring regulatory requirements were met
- Completed monthly audits to ensure claim practices were filed
- Compiled reports for Division Manager to review current claims status and proactively resolve issues
- Mentor staff and review performance including annual evaluations to identify improvement opportunities and address issues in support of personal and professional development goals
Casualty Claim Specialist
Southern United Fire Insurance
2005.01 - 2006.01
- Oversaw claim investigations for serious bodily injuries including fractures and fatalities
- Collaborated with defense attorneys to define legal strategies and collect evidence
- Assisted in completing pre-trial document
Education
Diploma - Business Administration And Management
Ann Arbor Huron High School
Ann Arbor, MI01.1983
Skills
Documentation Review & Analysis
Certification
3001154808, 3001163229, 7886146, 7886146, 002709527, 3001154864, W729390, 3396474, 825905, 3630106, DOI-1117982, 443454, ADN373701, 7886146, 40723162, 10730118, 7886146, 7886146, 7886146, 3628930, IA-1673252, 100126291, 7886146, 3001154779, 7886146, 1260439, 3629175, 1090584, 7886146, 454830
Professional Development
Required 24 hours of CE every two years in Texas
Timeline
Claims Adjuster
Gallagher Bassett
2023.02 - Current
Claims Adjuster
CPR Insurance Group
2021.12 - 2023.02
Claims Adjuster
Zurich IPS
2021.09 - 2021.12
Litigation Consultant
Sedgwick
2021.01 - 2021.09
Senior Claim Consultant
CCMSI
2020.07 - 2021.01
Claims Adjuster
Hammerman Gainer
2020.03 - 2021.01
Transportation Adjuster
The Littleton Group
2019.04 - 2020.07
Senior Claims Examiner
CRAWFORD & COMPANY
2016.01 - 2019.04
Claims Specialist
STATE AUTO FINANCIAL CORPORATION
2012.02 - 2015.11
Senior Claims Specialist
BRIGHTCLAIM, INC.
2008.01 - 2012.01
Casualty Claim Manager
Southern United Fire Insurance
2006.01 - 2008.01
Casualty Claim Specialist
Southern United Fire Insurance
2005.01 - 2006.01
Diploma - Business Administration And Management
Ann Arbor Huron High School
3001154808, 3001163229, 7886146, 7886146, 002709527, 3001154864, W729390, 3396474, 825905, 3630106, DOI-1117982, 443454, ADN373701, 7886146, 40723162, 10730118, 7886146, 7886146, 7886146, 3628930, IA-1673252, 100126291, 7886146, 3001154779, 7886146, 1260439, 3629175, 1090584, 7886146, 454830
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