Erica Fierros

• Assessed policy coverage for submitted claims and notified the insured of any issues; determined and established reserve requirements, adjusting reserves as necessary during the processing of the claims; refers claims to the subrogation group or Special Investigations Unit as appropriate.
• Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability, and damages.
• Independently investigates, evaluates, and negotiates third-party liability settlements with attorney involvement.
• Handled claims in which lawsuit was brought against the insured for property damage or bodily injury claims.
• Strategically planned next steps to take in a claim in which a lawsuit had been filed in order to most effectively protect the insured.
• Directed both Staff Legal Counsel and Fee Legal Counsel on the handling and information needed to support the defense.
• Attended mediation between Plaintiff counsel and Defense counsel to negotiate a fair settlement of the presented claims.
• Handled the states WA, CA, ID, and OR.

• Negotiated terms and handled settlements and adjustments with claimants and co-defenders.
• Interpreted policy details and recommended most favorable course of action.
• Referred extreme cases to Special Investigation Unit (SIU) for further review.
• Monitored expenses of pending claims to comply with company expenditure guidelines and budgets.
• Interviewed policyholders, witnesses and third parties to gather information and details regarding injury event.
• Interviewed relevant parties to determine claim denial or settlement.
• Conducted claims investigations by obtaining written statements, preparing reports, researching public records and conducting personal interviews.
• Evaluated coverage, liability and damages and investigated suspicious claims.
• Examined forms to determine insurance coverage. Determined liability and estimated and approved benefit payments.
• Examined claims forms and other records to determine insurance coverage.
• Verified insurance claims and determined fair amount for settlement.
• Answered customer questions regarding deductibles.
• Prepared summaries of damage, payments and policy coverage.
• Evaluated insurance policies and analyzed damages to determine coverage.
• Reviewed police reports, medical treatment records and physical property damage to determine extent of liability.
• Handle the states of WA, OR, CA, AZ, ID, MT, WY, ND, SD, UT, CO, KS, NM, TX, AK, HI, MN, IA, NE

Telephone Claims Representative II ( Pre-litigation Bodily Injury Adjuster)

• Processed Third party Bodily Injury and Under Insured Motorist a Bodily Injury claims.
• Assessed appropriate reserving for a life of a claim based on the injured parties past, current and future treatment.
• Responsible for obtaining all necessary medical bills and records needed to appropriately evaluate a fair settlement amount based on a parties injury claim.
• Once all documentation was on hand I was responsible for determining the value a bodily injury case would settle for.
• Specialized in the handling of negotiations for unrepresented claimants and claimants represented by legal counsel.
• Processed settlements to completion by acknowledging the applicable liens filed while gathering releases and issuing settlement drafts.

Telephone Claims Representative I

• Maintained a pending of claims in which I was responsible for managing all coverage, liability and damages.
• Processed first party medical claims (Personal Injury Protection and Medical Payments) Investigated what coverages would apply to a loss and compiled necessary supports to process any needed coverage denials or disclaimers of coverages as outlined in the policy contract.
• Investigated any disputes that would arise regarding who held the liability in a loss or how much a specific parties actions contributed to the liability.
• Transition to a coaching position assisting internally promoted employees and externally hired employees in transitioning from any training environment to the daily work environment.

Claims Customer Service Representative

• Responsible for applying knowledge of the policy contract to the motor vehicle accident at hand.
• Created new motor vehicle accidents losses. Handled customer inquiries about general claims practices, coverages, liability and vehicle damage repairs.
• Responsible to make clear coverage and liability decisions. Kept the insured informed of all motor vehicle accident proceedings.