Lisa Gray

I was hired in october 2021 by TM Ted Fiudo. My position upon hiring was a level 4 Claims Casualty Adjuster. This has now changed to one of 4 Complex Casualty Adjusters within ACMO.

I am responsible for high level, complex injuries and coverage issues. My responsibility is to maintain workflow according to guidelines, team manager, unit manager and exam team recommendations. I maintain a high level of client contact and efficiency while working thru to conclusion. My reports are timely and files are well managed. In 2023 I was awarded for Claims Excellence in claim handling. My claims handling also included litigation (prior to ligations department) and also knowledgeable participation in deposition testimony, mediations etc. Since my tenure at AAA, I have become familiar with all defense counsel staff and work with them to develop lawsuit handling. My defense interaction after the litigation department was established is obtaining defense to provide global settlement agreements, mediations, coverage and liability issues. My complex claim handling is well handled and accurately monitored for excellent claim handling. I have volunteered for the further of our ACMO team with participation in Claims Change Champions, liason with the ER department and assistance to other team members with questions and/or guideline questions. I am also backup to our Team Manager while out of the office.

• Negotiated cost-effective settlements with claimants by leveraging strong interpersonal skills and industry expertise.
• Supported policyholders during difficult times, providing empathetic service while managing claims objectively.
• Participated in ongoing training programs to continuously maintain knowledge of current industry trends and regulatory changes impacting casualty adjusting practices.
• Enhanced customer satisfaction with thorough claim investigations and prompt settlement negotiations.
• Improved claim resolution times by efficiently investigating and evaluating casualty insurance claims.
• Reduced fraud losses through diligent investigation of suspicious claims and collaboration with law enforcement agencies.
• Collaborated with legal teams to defend company interests in litigation matters related to casualty insurance claims.
• Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
• Managed a high volume of cases, ensuring timely and fair resolutions for clients.
• Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
• Optimized workload efficiency through prioritization of tasks based on claim complexity and time sensitivity.
• Researched claims and incident information to deliver solutions and resolve problems.
• Analyzed information gathered by investigation and reported findings and recommendations.
• Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
• Determined liability outlined in coverage and assessed documentation such from police and healthcare providers to understand damages incurred.
• Identified suspicious losses and contacted manager for investigative assistance.
• Maintained contact with claimants and attorneys to determine treatment status.

As a Sr. Claims Representative liability specialist I was responsible for complex bodily injury claims for both homeowners and casualty. I completed accurate evaluations, negotiations for positive claim solutions and provided testimony and deposition on litigated claims. I was a Sr. on my team which my experience provided assistance to others in helping to manage and provide positive input for the claim process. I had authority level of $75,000 with very minimal supervision necessary. I retired from this position in excellent standing and maintained relationships to continue my career to AAA.

• Developed strong relationships with clients, fostering trust and loyalty to the company.
• Negotiated settlement agreements that were mutually beneficial for both clients and the company while maintaining professional relationships.
• Reviewed medical records diligently when necessary for injury-related cases ensuring correct assessment was made regarding the claim.
• Enhanced customer satisfaction by providing timely and accurate claim resolutions.
• Offered support to new team members, acting as a mentor by sharing insights gained from years of experience in the field of claims handling procedures.
• Managed a high volume of claims, ensuring prompt attention to each case.
• Maintained comprehensive knowledge of insurance policies and regulations, leading to accurate decision-making on claim eligibility.
• Continuously improved personal knowledge of industry trends and developments through ongoing training initiatives, enhancing job performance capabilities.
• Investigated complex claims thoroughly, resulting in fair settlements for both parties involved.
• Coordinated with legal teams to handle litigation cases efficiently, reducing company liability risks.
• Decreased claim processing time by streamlining workflows and implementing efficient task prioritization.
• Prioritized workload effectively under pressure, consistently meeting deadlines without sacrificing quality or accuracy in claim processing tasks.
• Assisted colleagues with challenging cases, sharing expertise to reach successful outcomes for all parties involved.
• Worked productively in fast-moving work environment to process large volumes of claims.
• Developed in-depth understanding of insurance policies and procedures.
• Maintained strong knowledge of basic medical terminology to better understand services and procedures.

Multi line claim handling with field inspections. Investigation and claims included both personal auto and homeowners. Homeowners claim I was responsible for roof inspections, total fire losses, personal property theft and catastrophic injuries and personal property claims.

• Completed paperwork in full, on time and with high accuracy.
• Enhanced customer satisfaction by promptly addressing concerns and providing effective solutions.
• Kept up-to-date on industry trends, enabling informed decision-making during client engagements.
• Optimized route planning to minimize travel time while maximizing client visits, resulting in greater efficiency and cost savings.
• Improved territory coverage by strategically planning and efficiently executing daily tasks.

I was hired as a field claims service representative handling Homeowners specific including claims involving personal HO property damages as well as HO liability. I was promoted to a Bodily Injury Representative responsible for handling personal auto claims. The file was assigned specific and handling was completed entirely by the representative including liability and coverage determination and vehicle damage evaluations. Settlements were accomplished with attorney represented and non-represented claimants. Coordinated efforts of the claims department handling catostrophic losses with policyholders. I was selected to direct claim personnel in further education seminars and classes. Authority level included up to $50,000.

• Collaborated with appraisers for accurate damage assessments, resulting in fair compensation payouts.
• Prioritized workload effectively under pressure, consistently meeting deadlines without sacrificing quality or accuracy in claim processing tasks.
• Enhanced customer satisfaction by providing timely and accurate claim resolutions.
• Reviewed medical records diligently when necessary for injury-related cases ensuring correct assessment was made regarding the claim.
• Managed a high volume of claims, ensuring prompt attention to each case.
• Continuously improved personal knowledge of industry trends and developments through ongoing training initiatives, enhancing job performance capabilities.
• Decreased claim processing time by streamlining workflows and implementing efficient task prioritization.
• Developed in-depth understanding of insurance policies and procedures.
• Provided exceptional service to policyholders during catastrophes, ensuring their needs were met quickly and effectively.

WFL is a large insurance agency made up primarily of contractors and large corporations. I was responsible for claim department functions at an agency level and supervisor over department handling. This position provided client contact coordinating efforts with the insurance carrier. This interaction included keeping a client informed as to the claim coverage and litigation issues with company claim handlers to coordinate and maintain communication until claim settlement. I also was a resource in providing claims conference and introductions to client employees on claim handling in the workplace.

• Monitored performance metrics regularly, identifying areas for improvement and implementing corrective measures accordingly.
• Maintained up-to-date knowledge on industry trends, best practices, and regulatory changes to ensure optimal decision-making in the claims management process.
• Enhanced team productivity by providing ongoing training and mentorship to client employees and corporate owners.
• Oversaw the negotiation process between policyholders and insurance carriers, achieving equitable settlements on behalf of clients.
• Championed insurance claims process by providing expert knowledge and building positive, trusting relationship to support clients during challenging times.

Royal Insurance was a large commerical insurance carrier. Claims were assigned within an alphabetic range, large or small, Claims consisted of commercial policyholders including products liability for General Motors, General Liability policies for large corporate holdings of shopping malls including St. Louis Galleria, Crestwood etc. Claim investigations on/off site to determine liability and coverage issues. Responsible for handling fatality accident, property & litigation management.

• Proactively addressed potential complications within the claim process by identifying risks early on and implementing preventative strategies.
• Collaborated with adjusters and other professionals to accurately assess damages and determine appropriate settlements.
• Coordinated efforts between internal departments, including underwriting, billing, and legal teams in order to resolve complex claims issues.
• Increased customer satisfaction by efficiently managing and resolving insurance claims.
• Continually exceeded performance goals related to productivity, customer satisfaction, and claim accuracy – demonstrating commitment to excellence in all aspects of work.

A series of 3 promotions advanced quickly thru clerk, Technical assistant and claims representative. Responsibilities included handling of minor claims iincluding a full liability investigation, coverage decisions and conclusion of a claim with agreed settlement with represented and non-represented claimants.

• Developed in-depth understanding of insurance policies and procedures.
• Reviewed and updated claim processing guidelines, ensuring alignment with industry standards.