DEBRA LOPEZ
San Antonio,TX
Summary
Claims Adjuster with extensive experience in managing litigation claims and a proven track record of evaluating complex insurance cases to determine optimal resolutions. Skilled in analytical assessment of damage and liability, ensuring fair and efficient claim settlements. Posses understanding of policy coverage, complemented by effective negotiation techniques that drive successful outcomes. Committed to delivering exceptional service and maintaining strong relationships with our insureds .
Overview
19
19
years of professional experience
1
1
Certification
Work History
Sr. Injury Adjuster
USAA
02.2025 - Current
- Review claim to determine if coverage is afforded
- Take recorded statements from all parties involved
- Determine liability
- Set method of inspection and rental
- Review demands and complete evaluations
- Negotiated with attorney's and come to a settlement agreement
- Communicate with member/insured throughout the claim process
- Review suit documents and prepare litigation referral
- Monitor file for PIP, UM/UIM, Subrogation, & Litigation
- Send the appropriate letters attorney's, claimants and insureds
Litigation Adjuster
Fred Loya Insurance
09.2022 - Current
- Analyze policy language to verify coverage validity.
- Assess loss facts utilizing photographs, diagrams, police reports, and additional evidence to establish liability.
- Set proper reserves.
- Handle the distribution of various official correspondences, including ROR and settlement letters.
- Handle high exposure claims from the first notice of loss from severe objective injuries, such as those involving pedestrians, fractures and surgeries.
- Attend mediations, arbitrations, or other hearings as needed to negotiate settlements, and resolve disputes outside of court.
- Handle legal documents and maintain communication with defense counsel to ensure deadlines are met.
- Collaborate with defense counsel on expert selection.
- Assess medical bills, records, and recommended procedures.
- Monitor developments during trial proceedings in order to ensure that client interests are protected at all times.
- Evaluate and respond to demands promptly.
Bodily Injury Adjuster
Fred Loya Insurance
03.2022 - 09.2022
- Conducted interviews with claimants, witnesses, and medical professionals to obtain additional information about the claim.
- Handled the resolution of attorney-represented claims, ensuring timely and accurate evaluation of demands.
- Evaluated medical bills and records to assess the reasonableness and necessity of expenses incurred due to the accident.
- Attended mediations to settle cases, and to prevent litigation.
- Answered demands with their conditions promptly, as per regulations.
- Resolved various exposures through negotiations with plaintiffs' attorneys.
- Identified and forwarded suspicious claims to SIU.
Early Bodily Injury and Property Damage Claims Adjuster
Fred Loya Insurance
05.2019 - 03.2022
- Evaluated the extent of injuries and damages, determining coverage and liability in accordance with company policies and procedures.
- Conducted thorough investigations of unrepresented bodily injury claims by gathering and analyzing medical records, police reports, and statements.
- Handled property damage claims in a timely and effective manner.
- Answered phone calls live to avoid complaints and escalating calls.
- Negotiated settlements with claimants directly to achieve a fair and equitable resolution, balancing both parties' interests, in an attempt to avoid any delays and letters of representation.
Inside Auto Service Representative- Remote
Hartford Insurance
10.2015 - 05.2018
- Reviewed incoming appraisals from both preferred and independent auto repair shops, meeting all service level objectives for time and allowable repairs.
- Determine and accurately evaluate total losses, ensuring that claims were paid promptly and appropriately.
- Provided both internal and external customers with the highest level of service with each interaction and ensured proper follow-up steps were taken if needed.
- Communicated effectively with both collision repair shop management as well as Hartford management to ensure that any complicated or escalated situations were handled in an equitable and expedited manner.
- Selected and worked as an integral member of an elite claims team that helped contribute to and write claims handling policies and procedures.
- Participated in group problem solving communications and played an active role in team building activities.
Subrogation Desk Reviewer
ACCC Insurance
02.2015 - 10.2015
- Review 1st and 3rd party liability claims to determine recovery potential, and completed necessary steps to investigate liability to promote successful subrogation recoveries.
- Reviewed commercial and personal auto estimates submitted for subrogation review.
- Negotiated repair cost, liability and settlement with adverse carriers.
- Assisted in the recovery of overpayments for duplicate coverage, charges, etc.
Claims Adjuster
GAINSCO INSURANCE
10.2013 - 01.2015
- Examined damaged vehicles to determine the extent of structural, body, mechanical, electrical or interior damage.
- Negotiated repair cost estimates with shops.
- Identified and controlled Loss of Use claims by both 1st and 3rd party claimants.
- Evaluated and negotiated total loss vehicles utilizing industry standard valuation methods.
- Conditioned and determined Salvage Value on total loss vehicles.
- Desk Review/Photo Review- completed estimates/supplements with photos provided by insureds/claimants or repair shops.
- Settled Fast Track bodily injury claims in the field for non-represented claimants.
- Traveled when necessary for Catastrophe duty.
Claims Services (Various Positions)
Fred Loya Insurance
01.2007 - 05.2013
- Monitor capacity levels throughout the day to ensure appraisers time is optimized; load level assignments when necessary to ensure service level objectives were met.
- Contact customers to schedule appointments to have their vehicles inspected by the appropriate appraiser.
- Provide proper explanation of the company's Guaranteed Repair Program to customers; monitor incomplete assignment reports and take action to ensure all timeframes are met.
- Reviewed salvage with vehicle owner and received authorization to have vehicle moved to auction yard.
- Negotiate storage and tear down fees with repair shops.
- Set approved bids on salvage.
- Act as a physical damage resource to inside desk adjusters.
- Examined damaged vehicle to determine extent of structural, body, mechanical, electrical, or interior damage.
- Condition total loss vehicle and submitted value scope to Total Loss Department.
- Participated in catastrophe duties.
- Verified facts through scene photos and recorded statements.
- Negotiated charges with repair facilities for replacement and labor cost.
- Contacted involved parties to review the repair estimate.
- Reviewed field inspections to ensure that company procedures have been followed and that the most cost effective estimate was written.
- Made correction when required to repair and labor cost.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Reviewed incoming subrogation demands.
Education
High School Diploma -
Oliver Wendell Holmes
San Antonio, TX06-1992
Skills
- Claims investigation
- Insurance policies
- Automobile appraisals
- Exposure analysis
- Casualty and property loss
- Policy investigations
- Automobile claims specialist
- Accident scene investigations
- Claims negotiation
- Multitasking and organization
- Policy interpretation
- Damage assessment
- Decision-making
- Caseload management
Certification
All Lines License, 1472327, 2025-04-30
Timeline
Sr. Injury Adjuster
USAA
02.2025 - Current
Litigation Adjuster
Fred Loya Insurance
09.2022 - Current
Bodily Injury Adjuster
Fred Loya Insurance
03.2022 - 09.2022
Early Bodily Injury and Property Damage Claims Adjuster
Fred Loya Insurance
05.2019 - 03.2022
Inside Auto Service Representative- Remote
Hartford Insurance
10.2015 - 05.2018
Subrogation Desk Reviewer
ACCC Insurance
02.2015 - 10.2015
Claims Adjuster
GAINSCO INSURANCE
10.2013 - 01.2015
Claims Services (Various Positions)
Fred Loya Insurance
01.2007 - 05.2013
High School Diploma -
Oliver Wendell Holmes