Gregory Sims II
Garland,TX
Summary
Diligent adjuster with strong background in evaluating and processing claims effectively. Successfully resolved numerous complex cases by applying deep knowledge of policy provisions and regulatory requirements. Demonstrated proficiency in negotiation and customer service, ensuring fair outcomes and client satisfaction.
Overview
13
13
years of professional experience
1
1
Certification
Work History
PIP Claims Adjuster
GEICO, Government Employees Insurance
02.2025 - Current
- Managed business relationships with restoration vendors and customers
- Negotiated auto and medical bills from $2500 to $300,000 which in return, lowered company cost and improved customer satisfaction
- Managed new losses via inbound and outbound calls and act as a file owner to ensure first call resolution
- Managed task to ensure timely follow up for pending claims
- Utilized internal systems to records, track, issue payment and monitor auto insurance claims
- Used Lexis Nexis to obtain ISO reports to locate unknown insureds/claimants that have been involved in accidents
- Exceeded departmental goals for contacting insureds and claimants within 24 hours
- Managed a high volume of around 12 claims daily while maintaining 93% and above on quality reviews
- Administrative Leadership
- Thoroughly explained to co-workers the steps to handle claims focusing on Bodily Injury Property Damage policies efficiently. A resource to associates by giving insight on how to work claims to completion and maneuvering proper protocol to customers. With my expertise it gave my fellow team members shortened average handle time during claim handling, fully complete tasks, and meet target goals.
- Customer Service
- Offered convenient options for customers to obtain service for the damages to their vehicles. Focused precisely on the well-being of the customer through empathy to decipher what needs to be completed. As a result, this gave the customer piece of mind and comfort in knowing that their vehicle will be repaired sufficiently and in a timely manner.
Liability Adjuster
First Chicago Insurance
09.2023 - 01.2025
- Ran searches through TLO, Lexus Nexis, TXDOT, ISO for customer and 3rd party information
- Handled claims solely for a full investigation to make liability decisions
- Reviewed estimates and paid all parties accordingly
- Handled special investigations that included unlisted drivers, owners and vehicles
- Worked along with Underwriting to distinguish premiums for certain claims
- Filed Arbitration against third party companies to recovery medical and indemnity payments
- Investigated worker's injury to rule out any liability on third party property or other vendors involved
- Reviewed medical bills to filter and lower costs
- Litigation with attorneys on small settlements
Subrogation Adjuster
Amtrust
Dallas, TX
03.2023 - 08.2023
- Filed Arbitration against third party companies to recovery medical and indemnity payments
- Investigated worker's injury to rule out any liability on third party property or other vendors involved
- Reviewed medical bills to filter and lower costs
- Litigation with attorneys on small settlements
Catastrophic Adjuster
Progressive Insurance
Irving, TX
08.2020 - 02.2023
- Negotiated invoices from $2500 to $50,000 which in return, lowered company cost and improved customer satisfaction
- Managed business relationships with restoration vendors and customers
- Negotiated fees and settlements with repped and non-repped customers, repair shops, and salvage
- Handled high call volumes through Avaya system
- Received on average 10-12 New Claim Assignments daily
- Managed Power of Attorney forms and received Letters of Guarantee with lienholders to fulfill accounts with customers
Bodily Injury Adjuster
Hallmark Insurance
Plano, TX
11.2019 - 06.2020
- Managed Bodily Injury and Property Damage claims under high volume in a timely fashion
- Negotiated fees and settlements with repped and non-repped customers, reviewed demands
- Able to identify discrepancies and services not aligned with treatment for us to compensate fairly
- Ran ISO, TLO, Child Support scans
- Met deadlines on timed demands and followed up on ones still in need of attorney's review
- Managed transferred claims, emails, and documents from other adjusters while unavailable for further handling
- Managed high call volumes through ACD system
- Received on average 12-15 New Claim Assignments daily
Auto Liability / Total Loss Adjuster
Kemper / Alliance United (subsidiary of Kemper) Insurance
02.2017 - 11.2019
- Handled Bodily Injury and Property Damage claims under high volume in a timely fashion
- Negotiated fees and settlements with repped and non-repped customers, repair shops, and salvage
- Managed to handle transferred claims, emails, and documents from other adjusters while unavailable for further handling
- Handled high call volumes through ACD system
- Received on average 10-12 New Claim Assignments daily
Total Loss / 1st Stage Bodily Injury Adjuster
Empower Insurance
Carrollton, TX
02.2016 - 02.2017
- Handled Liability and Total Loss claims under high volume in a timely fashion
- Negotiated fees and settlements with repped and non-repped customers, repair shops, and salvage
- Managed transferred claims, emails, and documents from other adjusters while unavailable for further handling
Adjuster
Horace Mann Insurance
Irving, TX
01.2015 - 01.2016
- Managed vehicle claims with varying degrees of complexity and severity
- Reviewed and analyze coverage and apply policy conditions, provisions, exclusions and endorsements, pertinent to a variety of vehicle damage claims. Recognize and apply how jurisdictional issues impact the claim. Manage deductibles and coverage limits
- Contact appropriate parties to obtain relevant facts necessary to determine coverage, causation/damages and exposure with respect to the various vehicle coverage provided
- Investigates facts to establish negligence, determine liability, other sources of recovery and negotiate resolutions as appropriate. Manage fire, theft and other claims that require specialized investigation and utilization of internal and external experts in accordance with local laws
- Requests the appropriate inspection type based on the details of the loss to effectively and efficiently resolve the claim. When a Total Loss is determined, authorize payment through the Total Loss representative
Auto Physical Damage / Liability Adjuster
State Farm Insurance
Richardson, TX
04.2013 - 01.2015
- Consistently deliver a remarkable customer experience throughout the handling of lower complexity claims, identifying and ensuring prompt routing of claims to other functional areas.
- Receive and process claim information and communicate with internal and external customers via phone and other communication channels.
- Work in a team environment and manage low complexity/high volume work
Education
Bachelor's Degree - Business Marketing
Prairie View A&M University
Prairie View, TX05-2011
Skills
- Critical thinking
- Claims investigation
- Active listening
- Highly motivated
Accomplishments
- Registered an average of 5 claims per hour, exceeding company targets by 95%.
- Maintained a superior quality rating of 93% in file handling from 2025 to present, exceeding the 90% department goal.
- Maintained a consistent closing ratio of 90%.
Certification
- Auto Adjuster License
- Florida
- Louisiana
- Michigan
- Connecticut
- Delaware
- New Hampshire
- Oklahoma
- Kentucky
- South Carolina
- Wyoming
- Texas
- Vermont
- Iowa
- Blue Cross First Aid
- CPR Certification
Languages
English
Full Professional
Timeline
PIP Claims Adjuster
GEICO, Government Employees Insurance
02.2025 - Current
Liability Adjuster
First Chicago Insurance
09.2023 - 01.2025
Subrogation Adjuster
Amtrust
03.2023 - 08.2023
Catastrophic Adjuster
Progressive Insurance
08.2020 - 02.2023
Bodily Injury Adjuster
Hallmark Insurance
11.2019 - 06.2020
Auto Liability / Total Loss Adjuster
Kemper / Alliance United (subsidiary of Kemper) Insurance
02.2017 - 11.2019
Total Loss / 1st Stage Bodily Injury Adjuster
Empower Insurance
02.2016 - 02.2017
Adjuster
Horace Mann Insurance
01.2015 - 01.2016
Auto Physical Damage / Liability Adjuster
State Farm Insurance
04.2013 - 01.2015
Bachelor's Degree - Business Marketing
Prairie View A&M University