La Fern Reynolds
Surprise,AZ
Summary
Detail-oriented Auto Claims Specialist with extensive experience investigating complex claims involving multi-vehicle accidents, disputed liability, and policy coverage issues. Skilled in analyzing evidence, assessing liability under comparative negligence laws, and negotiating settlements within legal and policy frameworks. Adept at collaborating with internal teams and external vendors to streamline claim resolution, control costs, and support litigation. Known for delivering empathetic customer service, maintaining regulatory compliance, and driving timely, accurate claim outcomes in high-pressure environments.
Overview
2026
2026
years of professional experience
Work History
Regional Claims Owner III
Farmers Insurance Exchange
12 2024 - Current
- Investigate complex auto claims involving multi-vehicle accidents, disputed liability, unlisted drivers, and lapsed policies.
- Evaluate evidence (police reports, photos, statements, scene data) to determine fault and causation.
- Apply comparative negligence and state laws to assess liability and resolve claims accurately.
- Collaborate with damage specialists to assess loss, coordinate repairs, and manage total loss settlements.
- Interpret policy language to determine coverage and explain details to policyholders and third parties.
- Negotiate settlements within legal, policy, and authority guidelines.
- Communicate liability decisions to insureds, claimants, legal counsel, and internal teams.
- Document investigations, decisions, and communications in compliance with regulations.
- Provide empathetic, timely updates to customers throughout the claims process.
- Serve as a key contact during high-stress claims, offering clarity and support.
- Coordinate with subrogation, litigation, damage, and medical teams on high-exposure claims.
- Work with vendors (repair shops, rental agencies) to streamline handling and control costs.
- Ensure compliance with state laws, regulations, and company policies.
- Manage rental and storage expenses to reduce claim severity.
- Identify and refer fraud and subrogation opportunities.
- Support legal teams with documentation for litigated claims.
- Monitor open files to ensure timely progress and resolution.
Auto Injury Adjuster - 3rd Party
USAA - P&C Auto Insurance
10.2022 - 11 2024
- Completed required investigations on referred files within established timeframes.
- Investigated insurance claims to determine liability and damages.
- Assisted in fraud detection and prevention efforts by identifying suspicious claim activities.
- Analyzed policy provisions, legal documents and medical records.
- Assessed potential losses for insureds in accordance with applicable laws and regulations.
- Resolved claims for insureds by providing relevant policy details and excellent customer service.
- Resolved claim disputes through mediation and negotiation, minimizing the need for litigation.
- Established reserves for each claim based on analysis of the facts and applicable law.
- Coordinated with medical professionals to assess injury claims and determine compensation.
- Developed relationships with clients, underwriters, adjusters, brokers and other internal and external stakeholders.
- Negotiated total loss settlements by reasonably applying company estimates to benefit both client and company needs.
- Negotiated settlements with claimants, attorneys and other parties.
- Decreased loss ratios through fair and timely claim processing.
- Drafted correspondence related to claim investigations and settlements.
- Evaluated subrogation opportunities to identify recoverable funds.
- Documented date, parties involved and specific details about incidents.
- Coordinated activities between multiple departments within the company.
- Performed quality control reviews of claims files prior to closure.
- Utilized claim handling software to document and manage claim files efficiently.
- Engaged in continuous learning to stay current with industry trends and best practices in claims management.
- Advised management regarding trends in litigation costs or settlement values.
Complex Claims Adjuster
USAA - P&C Auto Insurance
05.2019 - 10.2022
- Managed a high-volume caseload of collision, comprehensive, and liability auto claims from first notice of loss through final resolution, ensuring timely and accurate outcomes.
- Conducted thorough investigations by analyzing police reports, photographs, repair estimates, and witness statements to determine liability and assess damages.
- Interpreted and applied policy coverage, limits, and exclusions in accordance with state-specific regulations to support sound claims decisions.
- Coordinated inspections with repair facilities and appraisers, reviewed and validated repair estimates and supplements for accuracy and fairness.
- Negotiated repair costs, total loss settlements, and diminished value claims with third parties and vendors, maintaining compliance with authority limits.
- Maintained detailed, audit-ready documentation in claims management systems (e.g., Guidewire), supporting regulatory compliance and internal quality standards.
- Delivered empathetic, initiative-taking communication to policyholders, setting clear expectations and providing consistent updates throughout the claims process.
- Collaborated cross-functionally with Total Loss, Subrogation, and Salvage teams to streamline workflows and enhance customer satisfaction.
- Identified and escalated potential fraud and subrogation opportunities to the Special Investigations Unit (SIU) and recovery teams for further action.
- Supported surge and Catastrophe (CAT) operations, demonstrating flexibility through extended hours, on-call rotations, and deployment travel as needed.
Education
Bachelor of Arts - Business And Managerial Economics
University of Phoenix
Tempe, AZ05-2026
Skills
- Claims Investigation
- Liability Assessment
- Policy Interpretation
- Negotiation
- Customer Service
- Conflict Resolution
- Cross-Functional Collaboration
- Vendor Coordination
- Regulatory Compliance
- Cost Management
- Fraud Detection
- Litigation Support
- Time Management
- Claims Software Proficiency
Affiliations
- Volunteer
- Tutoring
- Photography
- Swimming
Timeline
Auto Injury Adjuster - 3rd Party
USAA - P&C Auto Insurance
10.2022 - 11 2024
Complex Claims Adjuster
USAA - P&C Auto Insurance
05.2019 - 10.2022
Bachelor of Arts - Business And Managerial Economics
University of Phoenix
Regional Claims Owner III
Farmers Insurance Exchange
12 2024 - Current
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