KING VIRAJ LEGEND
IRVING,TX
Summary
Claims adjuster with 14+ years of experience working with various insurance companies negotiating and settling claims. Experience with homeowners / construction property damage claims as well as auto appraising and personal / general auto claims processing. Excellent negotiation skills with an eye for detail. Excellent time management and organization skills completing and settling cases efficiently and effectively. Conducted on-scene investigations to analyze complicated liability disputes including traffic light disputes and intersection disputes. Ability to analyze best claims practices and market trends. Ethical conduct to make sure that all terms and policies are followed and implemented. Customer and client focused approach to making sure the company and client gets the most appropriate outcome. Strong knowledge of business operations when negotiating cases or contracts. Strong computer skills, excellent written and verbal communication. Goal oriented and confident in my ability to exceed monthly quotas. Determined to learn and adapt in a high-paced or remote environment. Overall strong communication, critical thinking, problem resolution and interpersonal skills. Organized and detail-oriented Investigator dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems. Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes.
Overview
29
29
years of professional experience
1
1
Certification
Work History
Claims Adjuster
Markel / State National Insurance
11.2021 - Current
- Reviewing and adjusting CPI Repo claims for payment authorization
- Resolving and adjusting GAP and GAP PLUS claims for payment
- Resolving and adjusting Premium Deficiency and Repo Expense claims for payment
- Reviewing auto appraisal estimates from SCA, HEA and other companies for accuracy and cost effectiveness
- Reviewing and correcting files for accuracy prior to closing.
- Improved claim resolution times by efficiently managing a caseload of 200+ claims per month.
- Achieved high customer satisfaction ratings by providing clear and timely communication throughout the claims process.
- Conducted thorough investigations of complex insurance claims under supervision, reviewing evidence and analyzing relevant documentation.
- Mentored fellow adjusters on best practices and industry regulations, contributing to their professional growth and development.
- Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
- Provided exceptional customer service during emotionally difficult situations for policyholders following accidents or natural disasters.
- Evaluated coverage accurately by interpreting complex insurance policies and applying them to specific claim scenarios.
- Facilitated smooth transitions for policyholders during the claim process by liaising between various departments, ensuring all parties were informed and engaged.
- Examined claims forms and other records to determine insurance coverage.
Senior Auto Damage Appraiser
Property Damage Appraisers
11.2015 - 11.2016
- Photo and inspecting damaged auto vehicles including motorcycles and RV's
- Resolving claims coverage questions, auto damage estimating both in drive-ins and out in the field
- Resolving files to its completion, data entry and sending required DOI letters
- Maintaining a high level of customer service at all times and concluding the settlement and negotiating the dollar figure for all total loss vehicles
- Overseeing the salvage of all total losses not retained by insured or claimant.
- Achieved successful negotiation outcomes by employing effective communication and active listening skills.
- Built strong relationships with clients to understand their needs and provide tailored solutions.
- Managed high-pressure situations effectively, resulting in mutually beneficial agreements between parties.
- Mentored junior appraisers, sharing best practices for successful deal making and relationship building.
- Conducted thorough research on industry trends and market data to inform strategic decision-making during negotiations.
- Optimized company resources by streamlining negotiation processes, reducing time spent on less productive tasks.
- Trained colleagues on advanced appraisal techniques, enhancing the team''s overall skill set and effectiveness in securing favorable terms.
- Improved customer satisfaction by promptly assessing vehicle damage and providing accurate repair estimates.
- Streamlined the appraisal process for increased efficiency and quicker turnaround times.
- Collaborated with insurance adjusters to negotiate fair settlements for all parties involved.
- Reduced instances of fraud by conducting thorough investigations and maintaining meticulous documentation.
- Developed strong relationships with auto body shops, ensuring high-quality repairs at competitive prices.
- Ensured compliance with industry regulations and company policies while performing appraisals on a wide variety of vehicles.
- Participated in professional development opportunities to stay informed on the latest industry trends and best practices.
- Increased accuracy in repair estimates through continuous training in automotive technologies and materials.
- Effectively prioritized workload to ensure timely completion of assignments without sacrificing quality or attention to detail.
Auto Damage Appraiser
Kemper Insurance (Formerly Unitrin Insurance)
02.2005 - 10.2007
- Photo and inspecting damaged auto vehicles including motorcycles and RV's
- Resolving claims coverage questions, auto damage estimating both in drive-ins and out in the field
- Resolving files to its completion, data entry and sending required DOI letters
- Maintaining a high level of customer service at all times and concluding the settlement and negotiating the dollar figure for all total loss vehicles
- Overseeing the salvage of all total losses not retained by insured or claimant.
- Enhanced customer satisfaction by providing accurate and timely damage assessments for vehicles involved in accidents.
- Streamlined the appraisal process by implementing an efficient documentation system, resulting in faster claim resolutions.
- Promoted a safe working environment by adhering to established safety procedures while inspecting vehicles and reviewing repair shop safety protocols.
- Provided exceptional customer service by addressing concerns and answering questions promptly throughout the appraisal process.
- Expedited claim processing times through effective communication with insurance agents, streamlining approval processes for repairs or total loss payouts.
- Demonstrated expertise in various makes and models of vehicles, allowing for precise identification of necessary repairs during damage assessment.
- Maintained professional credibility by completing continuing education courses as required within the auto damage appraisal field.
- Leveraged strong negotiation skills when settling claims with repair shops, resulting in cost-effective outcomes for both clients and the company.
Auto Damage Adjuster
CKM Staffing, Various Temp Work With Insurance Companies
02.2001 - 01.2005
- Photo and inspecting damaged auto vehicles including motorcycles and RV's
- Overseeing the handling of any and all disputes concerning the entire claims process
- Sending the required DOI letters within specified time limits.
- Enhanced claim processing times by streamlining workflow and prioritizing tasks effectively.
- Improved customer satisfaction by efficiently addressing and resolving auto damage claims.
- Negotiated fair settlements with claimants, balancing their needs with company interests.
- Demonstrated versatility in adapting approach based on individual claim complexity or unique circumstances that may arise during handling.
- Consistently met or exceeded performance targets related to claim cycle time, accuracy, and customer satisfaction scores.
- Proactively communicated with clients throughout the claim process, setting clear expectations and delivering updates as needed.
- Leveraged strong negotiation skills when working with external partners such as body shops or salvage vendors.
- Served as a trusted resource within the team, providing support and guidance for colleagues when faced with challenging situations or complex claims.
- Documented all findings in concise reports.
- Created detailed assessments of damages to property and vehicles.
- Enhanced customer satisfaction by delivering honest advice to policyholders in regards to repair work and body shop processes.
Senior Field Adjuster
Allstate Insurance
05.2000 - 01.2001
- Photo and inspecting damaged auto vehicles including motorcycles and RV's
- Resolving claims coverage questions, auto damage estimating both in drive-ins and out in the field
- Conducting on-scene investigations including traffic light disputes
- Maintaining a high level of customer service at all times
- Concluding the settlement and negotiating the dollar figure for all total loss vehicles
- Overseeing the salvage of all total losses not retained by insured or claimant.
- Increased customer satisfaction by efficiently handling and resolving complex claims in a timely manner.
- Enhanced company reputation through thorough investigations, accurate assessments, and fair settlements.
- Established rapport with clients, fostering trust and ensuring clear communication throughout the claims process.
- Negotiated successful settlements with policyholders, minimizing disputes and maintaining positive relationships.
- Conducted thorough on-site inspections to accurately assess damages and determine appropriate compensation amounts.
- Stayed current with industry trends and regulations to ensure compliance in all aspects of work.
- Managed high caseloads by prioritizing tasks and maintaining strict deadlines for claim resolution.
- Improved interdepartmental communication by regularly updating supervisors on case progress.
Senior Field Adjuster
Progressive Insurance
01.1999 - 05.2000
- Photo and inspecting damaged auto vehicles including motorcycles and RV's
- Data entry and completed liability processing
- Overseeing medical payment claim
- Contributing to Bodily Injury evaluations, Uninsured Motorist evaluation Subrogation, Arbitration
- Conducted claims resolution, estimating damage to vehicles both in the drive-in and out in the field
- Conducted settlement of bodily injury claims and insured / claimant liability determination and resolution
- Concluding the settlement and negotiating the dollar figure for all total loss vehicles
- Conducting on-scene investigations including traffic light disputes
- Overseeing and evaluating medical claims including treatments made by injured clients
- Overseeing the salvage of all total losses not retained by insured or claimant.
- Increased customer satisfaction by efficiently handling and resolving complex claims in a timely manner.
- Enhanced company reputation through thorough investigations, accurate assessments, and fair settlements.
- Negotiated successful settlements with policyholders, minimizing disputes and maintaining positive relationships.
- Streamlined claim management processes by implementing efficient organizational strategies.
- Conducted thorough on-site inspections to accurately assess damages and determine appropriate compensation amounts.
- Coordinated with contractors, engineers, and other professionals to facilitate accurate damage evaluations.
- Improved interdepartmental communication by regularly updating supervisors on case progress.
- Built strong professional networks within the industry resulting in increased opportunities for collaboration.
- Reduced fraudulent claims by conducting detailed investigations, identifying discrepancies, and reporting findings as necessary.
- Managed high caseloads by prioritizing tasks and maintaining strict deadlines for claim resolution.
Claims Specialist
CSAA
01.1995 - 12.1998
- Handling both auto and property damage / homeowners claims from opening right through to completion
- Improved claim processing efficiency by streamlining workflows and implementing time-saving strategies.
- Reduced claim processing errors by conducting thorough investigations and accurately interpreting policy details.
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
- Settled complex claims fairly by applying critical thinking, negotiation skills, and detailed knowledge of insurance policies.
- Maintained accurate records by diligently updating claim files and ensuring all required documentation was submitted in a timely manner.
- Streamlined the claims process for clients with proactive case management, regular updates, and prompt resolution.
- Optimized work processes within the team by sharing best practices for evaluating evidence, validating coverage eligibility, and determining loss values.
- Upheld company reputation by adhering strictly to ethical guidelines when managing sensitive cases, ensuring fair and impartial treatment for all parties involved.
- Demonstrated adaptability by successfully managing a diverse range of claim types, including property damage, bodily injury, liability disputes, and more.
- Followed up with customers on unresolved issues.
- Escalated files with significant indemnity exposure to supervisor for further investigation.
- Negotiated with other involved parties to arrange settlements for maximum results.
- Checked documentation for accuracy and validity on updated systems.
- Overseeing the progress of vehicle repairs, issuing drafts
- Negotiating liability with claimant carriers, overseeing the handling of any and all disputes concerning the entire claims process
- Sending the required DOI letters within specified time limits and guidelines
- Evaluating the fair market value and the condition of vehicles for salvaged vehicle settlements, team facilitation, damaged appraisals, conflict resolution, mediation, litigation, subrogation, filing for arbitration on hard to resolve files
- Overseeing and evaluating medical claims including treatments made by injured clients
- Concluding the settlement and negotiating the dollar figure for all total loss vehicles
- Overseeing the salvage of all total losses not retained by insured or claimant.
Education
Master of Science - Forensic Psychology
Walden University
Minneapolis, Minnesota05.2014
Bachelor of Science - Psychology
Walden University
Minneapolis, Minnesota08.2011
High School Diploma -
Santa Cruz High School
Santa Cruz, CA06.1994
Skills
- Literate in Mitchell Estimating
- OCS Claims Systems
- Xactimate with Sketch
- CCC Pathways
- Knowledge of MS Office
- Computer Knowledge
- CCC Reports
- Familiar With Fraud Statutes
- Casualty and Property Loss
- Legal Proceedings Knowledge
- Accident Scene Investigations
- Claims Processing
- Policy Investigations
- Insurance Policy Coverage Knowledge
- Risk Management
- Best Practices Implementation
- Texas Claims Adjuster License
- Florida (Pending) Claims Adjuster License
- Ethical Conduct
- Attention to Detail
Certification
- Certificate of Completion, CSAA Claims Training School, Hayward, CA, 01/1995, 02/1995
- Certificate of Achievement, Fundamentals of Collision Estimating, 05/2000, 10/2000
- Certificate of Completion, Progressive Insurance, San Jose, CA, 02/1999, 01/2000
Languages
Hindi
Gujarati
Punjabi
Spanish
Place Of Birth
United Kingdom
Timeline
Claims Adjuster
Markel / State National Insurance
11.2021 - Current
Senior Auto Damage Appraiser
Property Damage Appraisers
11.2015 - 11.2016
Auto Damage Appraiser
Kemper Insurance (Formerly Unitrin Insurance)
02.2005 - 10.2007
Auto Damage Adjuster
CKM Staffing, Various Temp Work With Insurance Companies
02.2001 - 01.2005
Senior Field Adjuster
Allstate Insurance
05.2000 - 01.2001
Senior Field Adjuster
Progressive Insurance
01.1999 - 05.2000
Claims Specialist
CSAA
01.1995 - 12.1998
Master of Science - Forensic Psychology
Walden University
Bachelor of Science - Psychology
Walden University
High School Diploma -
Santa Cruz High School
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