Jamie S. Lako
Pittsburgh,PA
Summary
Responsible Senior Claims Adjuster with experience performing detailed investigations and researching issues. Skilled at interpreting laws, evaluating facts, inspecting damage and analyzing case facts. Handles over 200 caseloads per month and provides exceptional customer service to the client.
Overview
23
23
years of professional experience
Work History
Commercial Auto Liability Claims Examiner III
Tristar Risk Management
11.2022 - Current
- Conduct efficient claim examinations and investigations leading to the final resolution of liability claims, including matters in litigation, for the State of New York.
- Review, process and conclude assigned claims including investigation and evaluation of complex Commercial Auto property and casualty claims with a total incurred of $25,000.00 per SRAP limits.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Oversee and direct outside investigative service providers and work closely with the client and client counsel and investigative services to advance the claim to conclusion.
- Maintain an ongoing diary, prepare loss reports providing thorough analysis of liability and damages.
- Determine if subrogation and/or risk transfer exists and initiate recovery efforts at the direction of the client.
- Document all correspondence, reports, discussions and decisions in the claim file record. Provide outstanding service to the client.
- Use strong analytical and problem-solving skills to develop effective solutions for challenging situations.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Provided professional services and support in a dynamic work environment.
- Developed and maintained courteous and effective working relationships.
- Managed time efficiently in order to complete all tasks within deadlines.
- Organized and detail-oriented with a strong work ethic.
- Self-motivated, with a strong sense of personal responsibility.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
Auto Claims Representative
Sedgwick
04.2022 - 11.2022
- Investigate third party property damage claims for multiple commercial trucking companies to determine liability
- Handling new accounts as company acquires them
- Review and interpretation of policy language to determine coverage.
- Evaluated and investigated over 300 auto claims within seven months and decided whether insurer should pay claim.
Senior Adjuster
Port Authority of Allegheny County
05.2009 - 03.2019
- As one of three claims adjusters for self-insured entity with over 2,000 employees, was responsible for investigating claims through prompt and courteous contact with appropriate parties such as claimants, witnesses, medical providers and technical experts to determine extent of liability and damages
- Obtained all investigative reports ranging from police and CIB reports to medical records while documenting claim file activities in RiskMaster, a proprietary claims tracking system developed by UPMC
- Processed liability claims by gathering information to determine liability exposure, assigned reserve values to claims, making claim payments as necessary and settling claims up to designated authority level
- Processed assigned claims and determine benefits due pursuant to client contract; make timely claims payments and adjustments
- While communicating claim action/processing with claimant, client and appropriate medical contact, ensured claim files were properly documented and claims coding was correct
- When appropriate, negotiated disposition of claims with all parties within assigned authority within 30 days of assignment.
Cargo Claims Analyst
South Hills Movers
04.2008 - 02.2009
- Investigated and processed cargo claims under guidelines of the Carmack Amendment, including gathering facts, taking statements and photos
- This required knowledge of specific coverage forms and endorsements, including delineation between Common Carriers and Contract Carriers
- Expertise with numerous federal and state regulatory schemes involving transportation industry
- Negotiated settlements achieved through fact-based documentation and knowledge of rules and regulations surrounding cargo's transportation
- Gathered facts, took statements and photos and worked with customers to determine cause of damage or loss and where liability lies.
- Directed claims negotiations within allowable limit of $3,000.00 and supported successful litigations for advanced issues.
Non-Injury Liability Adjuster
Nationwide Insurance
11.2000 - 04.2008
- Investigated and resolved personal lines non-injury liability and medical claims
- Negotiated settlements and disposition of claims in accordance with prescribed authority and according to best claims practices
- Interviewed all parties and determined liability after reviewing and confirming all pertinent facts.
Education
Bachelor of Science - Psychology
Saint Vincent College
Latrobe, PA05.1991
Skills
- Active and effective listening
- Coverage Assessment
- Liability Analysis
- Liability Determination
- File and Record Management
- Accident scene investigations
- Property Damage Assessment
- Investigation techniques
- Planning and research skills
- Adaptability
- Relevant work experience
- Microsoft Office
Professional Accomplishments
- New York adjuster license
- North Carolina adjuster license with all reciprocal state licenses
- Experience with both Commercial and Personal lines.
- Produce a high-quality work product on advanced to complex General Liability claims through immediate contact and the effective investigation, reserving and adjustment of claims incurred by clients of third parties.
- Analyze first report to determine nature of loss, coverage provided, liability and scope of injury/damage.
- Maintain an active diary to monitor timely development of the file and timely disposition of the claims.
- Exercise good judgment in reaching final disposition of claim by evaluating nature of loss, liability, injury/damage, coverage provided and applicable limits.
- Identify potential claim issues and take appropriate steps to resolve them or to refer them for adjudication.
- Establish appropriate resources to reflect claim exposure.
- Coordinate vendor referrals for investigation and/or litigation management.
- Analyze reported liability claim to determine benefits due and to ensure ongoing adjudication of claims with company standards and industry best practices.
Timeline
Commercial Auto Liability Claims Examiner III
Tristar Risk Management
11.2022 - Current
Auto Claims Representative
Sedgwick
04.2022 - 11.2022
Senior Adjuster
Port Authority of Allegheny County
05.2009 - 03.2019
Cargo Claims Analyst
South Hills Movers
04.2008 - 02.2009
Non-Injury Liability Adjuster
Nationwide Insurance
11.2000 - 04.2008
Bachelor of Science - Psychology
Saint Vincent College
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