EMILY ROBINSON
Saginaw,TX
Summary
LICENSE INSURANCE ADJUSTER SUMMARY OF QUALIFICATIONS Highly ambitious and detail-oriented professional offering extensive claims and litigation experience within the insurance industry. Over 7 years of claims file review and handling knowledge, skilled at handling property damage, litigation, and auto liability Equipped with an in-depth understanding of insurance policies, statutes, and law Known for excellent interpersonal skills and the ability to present complex matters before upper management Articulate communicator with excellent customer service skills Proficient trainer of litigation for newly hired personnel.
Overview
7
7
years of professional experience
Work History
Property Claims Adjuster
FKS CLAIMS
2022.11 - 2023.02
- Conducts thorough investigations following claim handling guidelines and best practices, ensuring accurate and comprehensive assessment of property claims
- Makes informed decisions on property claims, including denial, settlement, or authorization of payments, based on coverage, field reports, and verified damage
- Engages in interviews, phone calls, and correspondence with insureds, claimants, vendors, carriers, witnesses, public adjusters, attorneys, etc., gathering crucial information to support claims and obtain proofs of loss
- Sets appropriate reserves and obtains recorded statements as necessary to facilitate efficient claims handling
- Reviews and evaluates property claims for coverage and determines appropriate claim handling procedures, ensuring compliance with required statutory time frames
- Interprets policy language and analyzes coverage issues across multiple policies and endorsements, effectively addressing diaries, emails, and voicemails
- Prepares technical claim documents and correspondence, ensuring accurate and concise communication throughout the claims process
- Generates comprehensive reports summarizing investigation findings, providing clear and well-supported conclusions
- Actively contributes to departmental efforts, emphasizing collaboration and teamwork to achieve shared objectives
- Demonstrates a commitment to continuous improvement and professional development, seeking opportunities to enhance skills and contribute to the overall success of the claims team
- Established timely contact with insureds, claimants, attorneys, and other parties involved in claims to gather accurate and comprehensive facts regarding the loss
- Confirmed coverage of claims by meticulously reviewing policies and relevant documents, ensuring adherence to all legal and contractual obligations
- Actively participated in the review and discussion of large loss activity with stakeholders, providing valuable insights and recommendations to facilitate effective decision-making
- Conducted thorough assessments of coverage, proactively identifying and addressing potential coverage issues to minimize risks and ensure fair and accurate claim settlements
- Determined liability for third-party claims by conducting comprehensive investigations, analyzing evidence, and collaborating with legal teams to reach equitable resolutions
- Methodically documented all relevant information obtained regarding damages, maintaining accurate and detailed records to support claim evaluations and settlements
- Efficiently managed the assignment of claim damage for inspection, coordinating with field experts to ensure timely and thorough assessments of losses
- Successfully handled and settled a diverse range of bodily injury, property damage, and litigated claims, negotiating fair and satisfactory resolutions for all parties involved
- Reviewed, accepted, rejected, and made claim tenders based on careful analysis of facts, policy provisions, and legal requirements
- Provided oversight for field assignments, ensuring timely inspection, accurate documentation, and reliable estimates of losses to facilitate prompt claim resolution
- Maintained organized files, comprehensive notes, and effective correspondence, effectively managing multiple tasks in a fast-paced environment to meet deadlines and deliver exceptional service
- Consistently maintained a detailed claim diary for the entire duration of each claim, ensuring accurate and up-to-date records of all activities, communications, and key milestones
- Adhered to all guidelines and claims expectations of clients, consistently delivering high-quality work and demonstrating a strong commitment to professionalism and customer satisfaction
- Successfully performed all assigned duties while also being proactive in taking on additional responsibilities as needed, contributing to the overall efficiency and effectiveness of the claims department.
Property Claims Adjuster
LEGIONS CLAIM SERVICE
2021.11 - 2022.12
- Examined claim forms, policies/endorsements, and client instructions to determine coverage; set loss reserves and control claims costs; conducted interviews, recorded statements, secured public records
- Negotiated and settled claims in accordance with business unit best practices; maintained an effective work
- List, diary of communications relative to my daily workload
- Maintained company reputation by complying with federal and state regulations
- Maintained high service standards and maintain professional and technical knowledge
Property Claims Adjuster
RYZE CLAIMS SOLUTION
2020.01 - 2021.08
- Maintain contact with field adjusters to ensure timely inspection and estimate/report submissions
- Review adjuster reports and estimates to ensure estimates are technically accurate and meet appropriate industry guidelines and standards for repair
- Understand and follow all Best-Practices guidelines to ensure that all client expectations are met
- Knowledge of insurance policies and appropriate application of coverage
- Confirm all appropriate file documentation is included for completion of the review process
- Ability to work with Xactimate/XACT analysis and collaborate on estimates
- Respond timely and appropriately to follow-ups/requests for the client
- Monitor and maintain individual queues to ensure that files are being completed in a timely manner
- Understand and work within multiple client systems, programs, and guidelines
- Assist with training adjusters on client specific requirements when necessary
- All other related duties as assigned
Property and Litigation Specialist
WARDLAW CLAIMS
2019.06 - 2019.12
- Prepared and Negotiated with Public Adjuster and Attorney for resolution of the case
- Managed a diverse inventory of all state's property damage lawsuit to include insured cases, AOB water mitigation, mold testing and remediation
- Reviewed the property claim in order to provide conflict resolution
- Set expectations concerning the claims process, explained the inspection and supplement
- Reviewed field adjuster's loss report, estimate and analysis of inspection and determined cause and origin of loss and issued payments according to policy contract
Physical Damage and Liability Damage Adjuster
E.A. Renfroe
2018.10 - 2019.05
- Assess policy coverage for submitted claims and notify the insured of any issues; determine and establish reserve requirements, adjust reserves as necessary during the processing of the claim
- Effectively use client's claim systems and technology to successfully enter and verify pricing information
- Plan and conduct investigations of claims to confirm coverage and to determine liability, compensability, and damages
- Determine and document, during the investigation process, the potential for subrogation and refer claims to the subrogation group as appropriate
- Work in a team environment handling complex bodily injury claims and high-volume work
- Assess actual damages associated with claims and conduct negotiations within assigned authority limits to settle claims
- Adhere to high standards of accountability, confidentiality, and professionalism while dealing with claim information
Physical Damage and Liability Damage Adjuster
Global Risk Solutions
2017.10 - 2018.10
- Handle Property Damage losses from inception to close; accepted inbound calls from customer; gathered Fact of Loss Statements and established Liability
- Setup Field Adjuster Assignments for estimates to be written on damaged property; setup Rental
- Reservations for customers while awaiting repairs on vehicles
- Issued payments for repairs of damaged vehicles.
Complex Liability Claims Adjuster
Worley
2016.11 - 2017.09
- Conducted to resolve property damage claims
- Reviewed policy language to determine coverage, evaluated estimates, photos, supplements
- Provided detailed explanation of policies, coverage, liability and damages
- Determine liability
- Issued payments negotiated disputes with all parties
Complex Liability Claims Adjuster
FKS Insurance Services
2015.10 - 2016.11
- Prepared and Negotiated with Public Adjuster and Attorney for resolution of the case
- Managed a diverse inventory of Florida property damage lawsuits to include insured cases, AOB water mitigation, mold testing and mold remediation
- Responsible for reviewing lawsuits and claim file handling for accuracy and defensibility and directing defense counsel throughout the litigation process in order to achieve an optimal outcome for the company
- Managed the case from initial evaluation through final order of dismissal
- Conducted analysis of the defensibility of the dispute through analysis of the policy, statutes and prevailing case law
- Presented complex cases before a panel of upper management in order to obtain authority on extraordinary legal issues
- Trained newly hired personnel in litigation and set expectations of their assigned manager and Citizens Property Insurance Company
Education
High School Diploma -
Liberty High School
Liberty MS05.1986
Skills
- Litigation Property Claims
- Excellent Negotiation Skills Microsoft Office
- Policy Interpretation Claims Investigations
- Licenses & Certifications
- Adjuster Licenses:
- TX, AK, AL, AR, AZ, CT, FL, GA, HI, IN, KY, LA, ME, MI, MS, NC, NM, NV, NY, OK SC, VT, WA
- Technical Acumen
- Skilled in Guidewire and Microsoft Suites – Excel, Word, Outlook, PowerPoint & Visio
- Experienced Claims Examiner with expertise in analyzing insurance claims and determining applicable coverage.
- Skilled in reviewing and evaluating damages to determine liability and develop resolution strategies.
- Proficient in settling claims in accordance with policy provisions and within authority level.
- Strong verbal and written communication skills, able to engage with claimants, attorneys, and policyholders.
- Knowledgeable in meeting state claims handling requirements and following internal guidelines.
- Committed to upholding Core Values of Integrity, Accountability, Communication and Teamwork, Innovation, and Customer Service
- Capable of performing coverage, liability, and damage analysis on all claim's assignments
- Skilled in preparing correspondence to all parties involved in claims process.
- Able to investigate allegations and determine facts based on evidence and recorded interviews.
- Familiar with completing actions to satisfy department of insurance and state regulations.
- Proficient in drafting disclaimers and reservation of rights letters for coverage issues
- Experienced in assigning investigations and appraisals to licensed insurance professionals.
- Skilled in negotiating settlements, mitigating losses, and controlling expenses.
- Excellent communication skills, both internally with claims management team and externally with insureds, claimants, and attorneys
- Willingness to assist in training existing and new Claims Examiners.
- Reserves Recommendations
- Interview Claimants
- Interior Water Damage Repair
- Communications Strategies
- Quality Assessments
- Computerized Indexing Systems
- Complex Problem-Solving
- Active Listening
- Willingness to assist in training existing and new Claims Examiners.
- Reserves Recommendations
- Interview Claimants
- Interior Water Damage Repair
- Communications Strategies
- Quality Assessments
- Computerized Indexing Systems
- Complex Problem-Solving
- Active Listening
Accomplishments
- Certifications: State Farm Auto Property Certifications; Xactimate Certified
Timeline
Property Claims Adjuster
FKS CLAIMS
2022.11 - 2023.02
Property Claims Adjuster
LEGIONS CLAIM SERVICE
2021.11 - 2022.12
Property Claims Adjuster
RYZE CLAIMS SOLUTION
2020.01 - 2021.08
Property and Litigation Specialist
WARDLAW CLAIMS
2019.06 - 2019.12
Physical Damage and Liability Damage Adjuster
E.A. Renfroe
2018.10 - 2019.05
Physical Damage and Liability Damage Adjuster
Global Risk Solutions
2017.10 - 2018.10
Complex Liability Claims Adjuster
Worley
2016.11 - 2017.09
Complex Liability Claims Adjuster
FKS Insurance Services
2015.10 - 2016.11
High School Diploma -
Liberty High School
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