Frandjina Jeanty
Lakeland,FL
Summary
Detail-oriented Complex Claims Adjuster with extensive experience in auto claims, liability investigations, and policy coverage analysis across major insurers, including USAA, Geico, and State Farm. Skilled in evaluating coverage concerns, determining liability, and resolving highly complex claims through thorough investigations, SIU referrals, and data-driven decision-making. Adept at handling comparative negligence disputes, reviewing prior loss history, and utilizing digital tools to streamline claim resolutions. Strong background in claims processing, customer service, and workload management, with experience supporting catastrophe (CAT) response operations and high-volume caseloads. Licensed in Florida, with a solid foundation in bodily injury claim assessments and medical documentation reviews. Known for efficient problem-solving, attention to detail, and delivering fair claim resolutions while maintaining compliance with state regulations and company policies.
Overview
8
8
years of professional experience
Work History
Complex Claims Adjuster
USAA
07.2023 - Current
- Investigates and determines coverage and liability, evaluates, negotiates, and settles highly complex auto claims
- Negotiates liability for comparative negligence (claimant or adverse carrier).
- Identifies coverage concerns, reviews prior loss history, determines, and creates Special Investigation Unit (SIU) referrals, when appropriate.
- Interacts with multiple parties to gather information (police reports, recorded statements, witness statements) determine liability.
- Resolves claims through proactive problem solving and decision making, within authority guidelines and under moderate super-vision, overcoming obstacles, and effectively prioritizing the workload.
- Supports members, business partners, and claimants, through use of varying communication channels to include utilization of digital tools to drive timely and effective resolutions through exceptional service.
- Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.
- Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours.
Claims Adjuster
Statefarm Insurance
12.2022 - 04.2023
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
- Negotiated and settled claims according to information presented through reports, research and data verification.
- Identified and obtained evidence to ascertain claim value.
Bodily Injury Claims Adjuster
Geico
12.2020 - 11.2022
- Answered customer questions regarding deductibles.
- Prepared summaries of damage, payments and policy coverage.
- Interviewed and spoke with claimants, witnesses, police officers, doctors and other parties to determine claim settlement or denial.
- Investigated and assessed property damage.
- Decided whether claims can be negotiated.
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
- Negotiated and settled claims according to information presented through reports, research and data verification.
- Drafted statement of loss to summarize damages, payments and underlying policy coverage.
- Interviewed claimants, medical specialists and employers to determine pertinent claim information.
Account Manager
Primo Water
07.2017 - 11.2020
- My responsibilities are but not limited to making outbound calls, answering inbound calls, updating account records, answer billing questions, taking payment, and managing my mailbox and voicemails.
- Oversaw multiple accounts and worked diligently to meet and exceed performance goals.
- De-escalated customer interactions by providing alternative tactics to solving problems and satisfying customer needs.
Education
BBA - Business Administration And Management
Bellevue University
Bellevue, NE05-2026
Skills
- Claims Adjuster Experience
- Settlement Negotiations
- Liability Determination
- Insurance Policy Coverage Expertise
- Payment Processing
- Decision Making
- Fraud detection knowledge
- Adaptability
- Effective Communication
- Problem-solving abilities
- Active Listening
- Medical Terminology & Injury Assessment
Languages
Haitian Creole
Native or Bilingual
Timeline
Complex Claims Adjuster
USAA
07.2023 - Current
Claims Adjuster
Statefarm Insurance
12.2022 - 04.2023
Bodily Injury Claims Adjuster
Geico
12.2020 - 11.2022
Account Manager
Primo Water
07.2017 - 11.2020
BBA - Business Administration And Management
Bellevue University
Similar Profiles
William HoWilliam Ho
Claims Adjuster, Automobile and Casualty at USAAClaims Adjuster, Automobile and Casualty at USAA
Richard ShannonRichard Shannon
Senior Property Claims Adjuster at USAASenior Property Claims Adjuster at USAA
DARIAN TAYLORDARIAN TAYLOR
Insurance Customer Support at USAAInsurance Customer Support at USAA