Manages time and resources to make sound claims adjusting decisions.
-Investigates and determines insurance policy coverage and the extent of liability concerning loss or damages involving personal auto claims, using discretion and independent judgment.
-Determines the most effective and efficient sequence of activities to make timely contact with all relevant parties and ensures that conditions are set for a timely and accurate assessment of damages, including the movement of vehicles to the appropriate location for inspection and repair.
-Interviews, collects and documents information from customers, agents and witnesses. Reviews police reports, medical information, and other data when appropriate.
-Interprets personal auto policies and analyzes information gathered to determine course of action.
-Investigates facts of loss and ensures that coverage and liability decisions are consistent with the report of the accident.
-Recognizes applicable exposures and endorsements and refers if appropriate.
-Identifies potential fraud and refers for investigation.
-Proactively communicates, updates and responds timely to customer concerns.
-Collaborates on property damage with other claims adjuster(s) as to liability, coverage and damage resolution as needed.
-Makes decisions about subrogation referrals.
-Negotiates with customers and claimant carriers to ensure coverage and liability are assigned properly.
-Manages claims inventory workload, including claims paperwork, diaries, and communications (hard copy, electronic mail and phone communications); issues payments as appropriate.
-Monitors and makes decisions related to rental, including availability and length of rental period.
-Identifies, negotiates and resolves claims including total losses.
-Gathers information on the status and treatment needs of injured person(s), most commonly for soft tissue injuries and mild-to-serious sprain/strain, and minor scarring, fractures or concussions.
-Evaluates, settles and issues payments for unrepresented bodily injury claims.
- Maintains accountability for day to day management processes such as, performance management, coaching and development, and training of claims representatives.
- Implements Claims initiatives via appropriate change management channels and processes and is responsible for organizational initiatives that improve the overall work environment.
- Reviews claims handling to ensure standards are being met and claims are on track for timely and accurate resolution. Determines the need for additional resources when complexity escalates.
- Reviews and authorizes claims settlements, coverage, and liability as required.
- Responds to elevated inquiries and complaints; resolves and/or further elevates issues as they arise.
- Identifies performance trends and directs the remediation of team member performance deficiencies.
- Maintains accountability for day to day management processes such as, performance management, coaching and development, and training of claims representatives.
- Implements Claims initiatives via appropriate change management channels and processes and is responsible for organizational initiatives that improve the overall work environment.
- Reviews claims handling to ensure standards are being met and claims are on track for timely and accurate resolution. Determines the need for additional resources when complexity escalates.
- Reviews and authorizes claims settlements, coverage, and liability as required.
- Responds to elevated inquiries and complaints; resolves and/or further elevates issues as they arise.
- Identifies performance trends and directs the remediation of team member performance deficiencies.
Manages time and resources to make sound claims adjusting decisions.
-Investigates and determines insurance policy coverage and the extent of liability concerning loss or damages involving personal auto claims, using discretion and independent judgment.
-Determines the most effective and efficient sequence of activities to make timely contact with all relevant parties and ensures that conditions are set for a timely and accurate assessment of damages, including the movement of vehicles to the appropriate location for inspection and repair.
-Interviews, collects and documents information from customers, agents and witnesses. Reviews police reports, medical information, and other data when appropriate.
-Interprets personal auto policies and analyzes information gathered to determine course of action.
-Investigates facts of loss and ensures that coverage and liability decisions are consistent with the report of the accident.
-Recognizes applicable exposures and endorsements and refers if appropriate.
-Identifies potential fraud and refers for investigation.
-Proactively communicates, updates and responds timely to customer concerns.
-Collaborates on property damage with other claims adjuster(s) as to liability, coverage and damage resolution as needed.
-Makes decisions about subrogation referrals.
-Negotiates with customers and claimant carriers to ensure coverage and liability are assigned properly.
-Manages claims inventory workload, including claims paperwork, diaries, and communications (hard copy, electronic mail and phone communications); issues payments as appropriate.
-Monitors and makes decisions related to rental, including availability and length of rental period.
-Identifies, negotiates and resolves claims including total losses.
-Gathers information on the status and treatment needs of injured person(s), most commonly for soft tissue injuries and mild-to-serious sprain/strain, and minor scarring, fractures or concussions.
-Evaluates, settles and issues payments for unrepresented bodily injury claims.
-Inspects vehicles and writes estimates in an accurate and timely manner, or may review the accuracy of estimates already written, appropriately documents claim related information, and makes decisions consistent with claims standards and local laws
-Proactively provides customers with information about the repair process and updates regarding the repair of their vehicle, or if the vehicle is not repairable may provide valuation information
-Sets clear and accurate expectations regarding repair duration, estimate detail, repair outcomes and financial obligation
-Develops and maintains relationships with vendors, including shop owners, managers and technicians, and salvage yard employees
-Completes estimates, updates PD Suite and meets productivity goals in an appropriate and timely manner
-Identifies related and unrelated damage (prior damage)
-Evaluates and executes payments of claims and resolution of claims without payments
-Makes total loss determinations and establishes total loss evaluations
-Reviews and assesses validity of all supplement requests
Discusses liability with at-fault entities and negotiates final settlement.
- Manages inventory and resolves or provides support for complex bodily injury, liability, coverage, product liability, and property damage subrogation claims.
- Handles incoming correspondence relating to claims in inventory.
- Settles damage disputes with at-fault carriers where they accept liability but contend Progressive has overpaid.
- Updates customers directly and regularly on claim status and answers subrogation questions from customers, claims employees, and others.
- Explains subrogation process and sets realistic expectations for customers regarding collections.
- Collects back deductibles and out of pocket expenses.
- Evaluates files for final course of action/next steps (e.g., closure, arbitration) based on facts of loss, contact information, and the balance of the claim.
- Coordinates inspections with the field and experts on product liability claims.
- Serves as a subject matter expert on the team and coaches less-experienced Subrogation Specialists; available to answer questions, and triage files.
- Grants settlement authority to Subrogation Specialists as needed and assists with onboarding new team members.
- Inspects and photographs damaged personal auto vehicle(s), most commonly for structural and frame damage, structural damage to the core support, uni-body damage, sheet metal damage, air conditioning and cooling.
- Inspects and photographs damaged Special Lines vehicles and competent in assessing complex damage for all of the core Special Lines products which are boats, motorcycles and recreational vehicles
- Estimates the cost of repair/replacement of damaged property, including making total loss decisions.
- Pursues appropriate options for replacement parts.
- Identifies questionable aspects of a claim and referring to a special investigator.
- Proactively communicates and sets and fulfills expectations with customers.
- Positions repair process options in relation to customers' needs.
- Negotiates prices with repair service providers prior to the conduct of repairs.
- Issues payments and reviewing requests for supplemental repair orders.
- Resolves total losses in the field.
- Identifies potential subrogation claims.
- Monitors repair and manages the customers expectation though the repair process.
- Maintains positive relationships with shops and vendors.
- Texas Property and Casualty License- 2004-Present
- National Employee Resource Group Ambassador
- Member of Arbitration Forums
- Texas Property and Casualty License- 2004-Present
- National Employee Resource Group Ambassador
- Member of Arbitration Forums