Karen Espinosa
Bodily Injury Claim Adjuster (Represented And Litigation)
Garland,TX
Summary
Experienced Bodily Injury Insurance Specialist and Supervisor successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 10 years of experience (7 years in litigation handing) and willingness to take on any challenge. Attentive team player skilled in mentoring, training, and educating peers.
Overview
10
10
years of professional experience
4
4
Certifications
1
1
Language
Work History
Supervisor Bodily Injury Claims
Alpine Rio F/k/a AspenMGA
Flower Mound, TX
04.2024 - Current
- Oversaw daily operations of 4-6 bodily injury specialist, ensuring smooth workflow and timely completion of tasks.
- Completed timely and comprehensive file reviews to ensure accurate and thorough claim handling practices.
- Managed and provided direction for the handling and successful settlement of high complexity and high severity files including but not limited to fatalities, burns, paralysis, amputations, scarring, and fractures.
- Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
- Strategized case approaches between clients, claim adjusters, and attorneys.
- Improved customer satisfaction with prompt and courteous resolution of inquiries and complaints.
- Handled claims consistent with client and corporate policies, procedures, best practices and regulations.
Bodily Injury Claims Specialist
SeaHarbor Insurance
Dallas, TX
07.2022 - 03.2024
- Enhanced efficiency by staying up-to-date on industry trends, regulations, and best practices in bodily injury claims management.
- Provided guidance to junior staff members on complex case scenarios involving multiple parties or liability disputes.
- Improved negotiation outcomes for settlements with meticulous documentation and clear communication.
- Reduced company exposure to potential lawsuits by identifying potential fraud and adhering to legal guidelines during claim handling.
- Participated in team meetings and contributed valuable insights that led to improvements in overall claim handling strategies.
- Provided support to colleagues in the resolution of complex claims, sharing expertise and knowledge as needed.
- Conducted full claim investigations and reported updates and legal actions.
Bodily Injury Claims Specialist
State Farm
Richardson, TX
09.2015 - 06.2022
- Negotiated bodily injury settlement agreements to resolve disputes. Including meeting all time limit demands.
- Partnered with legal counsel on litigation cases.
- Maintained contact with claimants and attorneys to determine treatment status.
- Applied jurisdictional laws, statutes, and guidelines in claim handling.
- Answered questions posed by insured and attorneys.
- Substantiated legitimate claims and denied unjustified claims.
- Handled first party (UM/UIM) handling, third party handling (liability), and Personal Injury Protection (PIP).
- Attended mediation or arbitration hearings when necessary, representing the company's interests professionally and effectively.
Education
No Degree - Marketing
Texas State University
High School Diploma -
Richardson High School
05.2009
Skills
Claims Investigation
Staff management
Decision-making
Customer service
Attention to detail
Analytical thinking
Complex Problem-solving
Insurance regulations knowledge
Policy Interpretation
Litigation Management
Settlement Negotiation
Liability Assessment
Coverage assessments
Team building
Certification
Texas Adjuster License - Active
Timeline
Supervisor Bodily Injury Claims
Alpine Rio F/k/a AspenMGA
04.2024 - Current
Bodily Injury Claims Specialist
SeaHarbor Insurance
07.2022 - 03.2024
Bodily Injury Claims Specialist
State Farm
09.2015 - 06.2022
High School Diploma -
Richardson High School
No Degree - Marketing
Texas State University