Eva M. Trahan
Senior Litigation Adjuster Complex/Casualty Claims
Greater Houston Katy ,Tx
Summary
An experienced licensed litigation adjuster with over 15 years of insurance knowledge which allows me to utilize my expertise in the handling of complex claims while providing exemplary customer service in the Litigation of Complex and Casualty Claims. I'm industrious, reliable, committed professional skilled in investigating and analyzing liability in personal, casualty and property losses. I have Excellent communication skills with a proven history in delivering excellent negotiation techniques to facilitate and leverage settlements demonstrated through years of experience in interviewing specialists, witnesses and claimants alike, while conscious of deadlines, possessing sense of urgency remaining creative and critical in problem-solving tactics. Im able to intuitively Identify risk and and needs and provide direction to initiate logical and effective solutions. I honor the confidential nature of information and work efficiently in any environment, simultaneously handling and managing evolving tasks.
Overview
19
19
years of professional experience
Work History
Senior Litigation Claims Adjuster
Allstate Insurance Co
01.2022 - Current
- Handle the largest and most complex bodily injury, uninsured, and underinsured liability claims including coverage and liability dispute on litigated and non-litigated claims.
- Substantiated legitimate claims and denied unjustified claims.
- Mitigated risks and increased profitability with well-developed strategies for reducing future claims and costs.
- Trained other claims staff members on proper handling and evaluation of injury claims.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Documented information gathered in field and uploaded data to company database for efficient processing using multiple systems.
- Synthesized data into comprehensive quarterly written reports for management.
- Testified on behalf of agency as part of criminal and civic proceedings.
- Presents cases and make recommendations for authority to management at roundtables
- Manage litigated claims by developing litigation plans, strategies and directing defense counsel through the litigation processing accordance with litigation management protocols
- Negotiate and communicate effectively with medical providers, attorneys, customers, and vendors for resolution of claims
- Attend arbitrations and/or settlement conferences, mediations and trials for claim resolution
- Make equitable inability decisions by regularly resolving disputes between policy holders and claimants by obtaining recorded statements, reviewing police reports, and contacting and obtaining witness statements
- Provide litigation management by assessing the strengths and weaknesses of lawsuits and develop plans of action for defending and disposing of the same.
Damage & Injury Claims Adjuster Supervisor
GEICO Insurance
01.2014 - 01.2021
- Responsible for the analysis and management of claim files within both the property and bodily injury units
- Provide daily support to claim staff on claim management and filing activities
- Resolve escalated customer concerns and complaints with prompt and fair claims handling
- Negotiate and communicate effectively with medical providers, attorneys, customers, and vendors for resolution of claims
- Assist in preventing losses due to insurance fraud and working side by side with the Special Investigations Unit
- Make equitable inability decisions by regularly resolving disputes between policy holders and claimants by obtaining recorded statements, reviewing police reports, and contacting and obtaining witness statements
- Provide litigation management by assessing the strengths and weaknesses of lawsuits and develop plans of action for defending and disposing of the same
- Attend depositions, mediations and trials/court appearances for settlement of Auto BI, PD UMBI, UIMBI & PIP claims
- Create and document claim files to comply with company guidelines and state regulations.
- Answered customer questions regarding deductibles.
- Prepared summaries of damage, payments, and policy coverage.
- Evaluated insurance policies and analyzed damages to determine coverage.
- Substantiated legitimate claims and denied unjustified claims.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Researched and analyzed policy contracts to verify proper payment of claims.
- Documented all investigation activity and presented reports to management.
- Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Handled customer complaints, resolved issues, and adjusted policies to meet changing needs.
- Monitored workflow to improve employee time management and increase productivity.
- Achieved results by working with staff to meet established targets.
- Maintained compliance with company policies, objectives, and communication goals.
- Enforced rules and regulations outlined in company manual to set forth expectations comprehensibly and consistently.
- Created successful work schedules for each team member to maintain deadlines and fully staff shifts.
- Conducted routine inspections to check quality and compliance with established specifications.
- Developed and implemented customer service policies to enhance satisfaction.
- Generated reports detailing findings and recommendations.
- Created and managed project plans, timelines and budgets.
- Devised and implemented processes and procedures to streamline operations.
- Maintained database systems to track and analyze operational data.
Customer Service Representative
Travelers Insurance
01.2005 - 01.2013
- Proactively sold personal insurance products as needed
- Reviewed and corrected personal property and casualty policies
- Compiled underwriting reports and perform statistical analysis
- Mentored new hires for Personal Insurance Counseling
- Developed product, underwriting and sales knowledge to counsel and sell available insurance products
- Used a computer to effectively capture claim loss information from customers via phone in a prompt and efficient manner
- Consistently provided top-tier, high-level customer service to ensure our customers feel secure, respected and cared for
- Used online reference material and resources
- Shared customer concerns and any telephone or system issues with Unit Manager to promptly and effectively address or prevent any issues.
- Handled customer inquiries and suggestions courteously and professionally.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Answered constant flow of customer calls with minimal wait times.
- Updated account information to maintain customer records.
- Responded to customer requests for products, services, and company information.
- Processed customer service orders promptly to increase customer satisfaction.
- Maintained up-to-date knowledge of product and service changes.
Skills
- Claims File Management Processes
- Medical Terminology & Injury Evaluation
- Data Analysis & Evidence Review
- Insurance Policy Coverage Knowledge
- Strong Communication and Interpersonal
- Texas All- Lines Adjuster License
- Settlement Determinations
- Courtroom Procedures
- Liability Determinations
- Policy Investigations-Determine Coverage
- CCC Pathways
- Best Practice Implementation
- Underwriting Knowledge
- Litigation Resolution
- Complex Cases
- Regulatory Compliance
- Cost Control & Appraisal Reviews
- Service Quality Monitoring
- Interviewing & Investigation Techniques
- Verbal and Written Communication
- Personal, Casualty and Property Loss
- Valuation Knowledge
- Legal Processes & Litigation support
- Risk Assessment Software
- Reserves Recommendations
- Legal Proceedings Knowledge
- Negotiation and Mediation Skills
- Subrogation Expertise
- Claim Validity Determination
- MS Office(Word, Excel, Outlook)&Cisco Systems
Timeline
Senior Litigation Claims Adjuster
Allstate Insurance Co
01.2022 - Current
Damage & Injury Claims Adjuster Supervisor
GEICO Insurance
01.2014 - 01.2021
Customer Service Representative
Travelers Insurance
01.2005 - 01.2013
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