Summary
Overview
Work History
Education
Skills
Affiliations
References
Timeline
Generic

Donna Roche

Pelham,NH

Summary

Detail-oriented Examiner with 30 years of experience. Strong command of conflict resolution and negotiation combined with excellent reporting and research skills. Thorough understanding of claims process for property damage and environmental claims.

Overview

29
29
years of professional experience

Work History

Senior Casualty Claims Adjuster

Farmers Insurance Exchange
08.2019 - Current
  • Investigate, adjust, negotiate commercial third-party liability property claims from inception while adhering to Company protocols
  • Recognize coverage issues and possible excess exposure along with risk transfer
  • Review for accurate and timely reserves.
  • Negotiate claims to settlement with plaintiff's counsel and claimant’s for property damage.
  • Resolved complex, severe exposure claims using high service oriented file handling.
  • Worked with private investigators and attorneys on preparation of evidence, witness statements and other documentation in preparation for trial.
  • Analyzed information gathered by investigation and reported findings and recommendations.
  • Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
  • Directed claims negotiations within allowable limit of $1 - $2,000,000 and supported successful litigations for advanced issues.

Senior Claims Adjuster

MetLife Auto & Home
04.2010 - 08.2019
  • Investigate, adjust, negotiate homeowner third-party liability claims from inception while adhering to Company protocols
  • Handle a range of damage claims from $1 to high exposure multiple party cases to include arbitration, mediation, and jury trials
  • Recognize coverage issues and possible excess exposure along with risk transfer
  • Review for accurate and timely reserves
  • Handle litigation files for policyholiders and directly against the Company
  • Testify on the Company's behalf when warranted
  • Interact with defense counsel in the defense of insureds subsequent to the initiation of litigation
  • Negotiate claims to settlement with plaintiff's counsel, insured’s and claimant’s for property damage
  • Evaluate and analyze contamination reports to determine appropriate coverages and damages
  • Handled environmental claims including oil spills, ground water contamination, and mold
  • Work closely with outside vendors on oil claims
  • Prepare training classes for oil claims.
  • Investigated and processed Third-Party Liability insurance claims for policyholders.
  • Investigated properties to determine extent of damage and estimate repair costs.
  • Trained other claims staff members on proper handling and evaluation of injury claims.

First Party Homeowner Adjuster

MetLife Auto And Home
03.2008 - 04.2010
  • Investigate, adjust, negotiate home first party claims from inception while adhering to Company protocol
  • Recognize coverage issues and possible excess exposure cases
  • Set up and work with outside adjuster/vendors for inspection of properties
  • Use Xactimate to write estimates.
  • Examined claims forms and other records to determine insurance coverage.
  • Clarified coverage of losses to policyholders and provided assistance in itemizing damages and finding alternative living arrangements.
  • Assisted homeowners by coordinating vendor services, emergency repair, cleaning and contractors.

Senior Auto Adjuster

MetLife Auto And Home
12.1994 - 03.2008
  • Investigate, adjust, negotiate auto bodily injury liability claims from inception while adhering to Company protocol
  • Handle cases ranging from soft tissue injuries to fatalities to include arbitration, mediation, and jury trials
  • Recognize coverage issues and possible excess exposure cases
  • Handle litigation files for our insured and directly against the Company
  • Interact with defense counsel in the defense of insureds subsequent to the initiation of litigation
  • Negotiate claims to settlement with plaintiff's counsel, insured's and claimant’s for property damage and bodily injury claims.
  • Reviewed police reports, photographs and other documentation to gain complete understanding of accident.
  • Used critical thinking to break down problems, evaluate solutions and make decisions.
  • Cultivated interpersonal skills by building positive relationships with others.
  • Successfully negotiated settlements with claimants and insurers.

Education

Bachlors of Science in Criminal Justice -

University of Massachusetts Lowell
Lowell, MA
12.1994

Associates Degree in Legal Administration -

Castle College
Windham
06.1992

Skills

  • Relationship Building
  • Active Listening
  • Critical Thinking
  • Policy Investigations
  • Claims Evaluation
  • Decision-Making
  • Liability Determination
  • Settlement Negotiations

Affiliations

  • NH Notary Public
  • NH Adjuster License and maintain 13 others

References

Available upon request

Timeline

Senior Casualty Claims Adjuster

Farmers Insurance Exchange
08.2019 - Current

Senior Claims Adjuster

MetLife Auto & Home
04.2010 - 08.2019

First Party Homeowner Adjuster

MetLife Auto And Home
03.2008 - 04.2010

Senior Auto Adjuster

MetLife Auto And Home
12.1994 - 03.2008

Bachlors of Science in Criminal Justice -

University of Massachusetts Lowell

Associates Degree in Legal Administration -

Castle College

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Donna Roche