ERWIN SANJUAN
Tampa,FL
Summary
Seasoned Litigation Adjuster with comprehensive experience in managing and resolving claims. Possess strong knowledge of insurance laws, policy provisions, investigation techniques and negotiation skills. Noteworthy for consistently reducing company costs through effective claim handling while maintaining high standards of service. Actively contributed to team efforts leading to improved performance levels and client satisfaction.
Overview
30
30
years of professional experience
1
1
year of post-secondary education
Work History
PIP Litigation Adjuster
National General Insurance Company
Tampa, Florida
06.2014 - Current
- Evaluated claims for liability, coverage, and damages consistently.
- Collaborated with legal teams to prepare for court proceedings effectively.
- Analyzed policy documents to determine claim eligibility and compliance.
- Negotiated settlements with claimants to resolve disputes amicably.
PIP/ Medical Payments Adjuster
Access General Insurance
Tampa, FL
05.2010 - 05.2014
- Investigate, evaluate, and settle 1st party claims in accordance with the terms and conditions of the policy contract
- Provide prompt and efficient claims service resolution
- Review policies, claim forms and managing all external communications with the customer, attorneys and medical staff to determine injuries and determining / establishing reserve requirements
- Analyze obtained documentation and evidence; evaluate coverage, determining liability, extent of damages and associated compensation
- Document records, update status notes, results of external information gathering and relevant medical reports and opinions
- Maintain accurate claims and investigative reports, recordkeeping and the handling of all administrative responsibilities associated with the processing and payment of claims
- Staying current on claim settlement process, process and procedures ensuring strict adherence of all company policies and practices and state regulations and statues
- Recognize and forward appropriate files to subject matter experts i.e… SIU, Nurse Review - Currently adjusting and settling moderately complex Bodily Injury claims
- Severity of claims includes soft tissue losses involving neck injury and back injury
PIP Adjuster, SIU & Subrogation Specialist
Direct General Insurance
Tampa, FL
05.2008 - 05.2010
- Investigate, evaluate and settle automobile claims involving 1st and 3rd party claims in accordance with the terms and conditions of the policy contract applicable to the liability facts and damages
- Provide prompt and efficient claims service and resolution
- Receive and record incoming auto loss reports, verify policy coverage and discuss claims process with client
- Worked in SAU- Special Adjustment Unit, investigating questionable and possible fraudulent claims alongside SIU Department
- Review and evaluate complex liability claims to identify subrogation potential. Recover monies paid for damages from responsible parties such as uninsured or underinsured motorists and other carriers
Casualty Claims Adjuster
USAA
Tampa, FL
09.1996 - 11.2007
- Investigate, evaluate and settle automobile claims involving 1st and 3rd party claims in accordance with the terms and conditions of the policy contract applicable to the liability facts and damages for FL, GA, SC, NC, MS, LA, TN & KY
- Provide prompt and efficient claims service and resolution
- Receive and record incoming auto loss reports, verify the policy coverage and discuss claims process with client
- Attend and participate in self-development training to acquire appropriate skills as well as complete CE courses as required to maintain 620 License
Auto Claims Adjuster
USAA
Tampa, FL
07.2000 - 12.2004
Rental Unit Coordinator
USAA
Tampa, FL
12.1998 - 07.2000
Property Claims Adjuster
USAA
Tampa, FL
06.1998 - 12.1998
General Clerk
USAA
Tampa, FL
09.1996 - 06.1998
Education
Casualty Claim Law Associate - Insurance And Risk Management
Insurance Institute of America
06.2003 - 12.2003
High School -
Plant City High School
Plant City, FLSkills
- Microsoft Excel
- Word Perfect
- Microsoft Word
- Outlook
- Team Player
- Professionalism
- Bilingual FLUENT Spanish
- Claim evaluation
- Legal collaboration
- Policy analysis
- Risk assessment
- Conflict Resolution
- Analytical thinking
- Detail orientation
- Time management
- Excellent and Effective communication
- Organizational skills
- Problem resolution
- Teamwork and collaboration
- Flexible and adaptable
Synopsis Of Achievements
- Served 4 years in the U.S. Air Force as a Telephone Switching Technician.
- Acquired 620 License while working as a clerk at USAA.
- Certified completion in Property & Liability from the Insurance Institute of America.
- Awarded the designation of Casualty Claim Law Associate by the Insurance Institute of America, 12/01/2003.
Timeline
PIP Litigation Adjuster
National General Insurance Company
06.2014 - Current
PIP/ Medical Payments Adjuster
Access General Insurance
05.2010 - 05.2014
PIP Adjuster, SIU & Subrogation Specialist
Direct General Insurance
05.2008 - 05.2010
Casualty Claim Law Associate - Insurance And Risk Management
Insurance Institute of America
06.2003 - 12.2003
Auto Claims Adjuster
USAA
07.2000 - 12.2004
Rental Unit Coordinator
USAA
12.1998 - 07.2000
Property Claims Adjuster
USAA
06.1998 - 12.1998
Casualty Claims Adjuster
USAA
09.1996 - 11.2007
General Clerk
USAA
09.1996 - 06.1998
High School -
Plant City High School