Mark S. Maczka
Williamsville,NY
Summary
Twenty three years of claims management in the Property and Casualty Insurance Industry, including customer service. Areas of expertise include property outside/inside claim handling, liability claims, complex to minor losses including catastrophe claims and training. Responsible for all aspects of claim handling, from initial contact, investigation, inspection, first call settlements, and subrogation. This includes, adhering to Cycle Times and Best Practice guidelines. Excellent integrity, time management, goal setting, customer service, communication, team building, problem solving, and computer skills.
Overview
24
24
years of professional experience
Work History
Senior Outside Claims Adjuster/Inside
National General Insurance Company/Allstate Corporation
01.2021 - Current
- Maintain New Your State Licensed Adjuster for nine years
- Currently adjusting claims in New York, Ohio, Illinois, Michigan, Wyoming, Utah and various states as required
- Certified using Xactimate for property estimating and claim adjustment
- Review of Polices and Endorsements to determine coverage
- Adjustment of First Party claims including Third Party Liability Claims
- Adhering to state codes and guidelines for effective claim resolution
- Staff training, including Independent Adjusters pertaining to Policies, Xactimate, Company Guidelines and Best Practices
- General Adjuster large loss Claims adjustment including
- Claims assignments to Independent Adjusters, based upon regions per state for expedient claims handling
- Maintained diaries to expedite claims process and consistent file documentation, based upon company guidelines
- Recorded Statements to identifying Subrogation and assignment for claim recovery
- Review of claims with Insurance Carriers Claim Legal Department to identify coverage
- Drafting of Reservation of Rights, Disclaimer, Payment correspondence with Agents and Insureds
- Maintaining communication and relationships with Policy Holders, Agents, Departments within Insurance Carrier, Vendors and Independent Adjusters
- Negotiating claims with Public Adjusters per State while adhering to policy guidelines and best practices
- Achieved high customer satisfaction ratings by providing clear and timely communication throughout the claims process.
Outside Claims Representative- Independent Adjuster
A.E. Mahoney & Co., Inc.
01.2015 - 01.2021
- New York State Licensed Adjuster
- Currently representing over 10 Insurance Carriers throughout New York State, acting as the liaison between the insured, agents, and the aforementioned insurance carriers
- Been able to maintain, and build upon, the numerous relationships between A.E. Mahoney & Co., Inc. and the various Insurance Carriers
- Maintained same-day, next-day contact with the insured and inspections within 48-hours
- Performed investigations, while simultaneously, confirming and interpreting coverage
- Retained cause and origin experts, engineers, and building consultants as needed, with approval from the respective Insurance Carriers, including obtaining police and fire reports
- Responsible for proper and timely reserves, reporting to the Insurance Carrier, while adhering to insurance carriers’ cycle times and reporting
- Identified subrogation and maintained evidence for Insurance Carriers
- Currently utilizing Xactimate in order to estimate claims and File Track as a means of maintaining diaries and other forms of data entries
- Reviewing contractors’ estimates, by using Xactimate, in order to ensure accuracy, legitimacy, Proofs of Loss, prior to making settlement of claims
- Tasked with writing preliminary, status, and final reports, including declination letters, to the Insurance Carriers for approval
- Promoted teamwork between peers, outside organizations, and the represented Insurance Carriers
Outside Claims Representative
The Travelers Insurance Companies, Inc.
01.2002 - 01.2015
- Effectively ascertained the following: Contact, coverage, scope, estimates and investigation of claims Identify subrogation potential, as well as identifying potential fraudulent claims and involvement of Special Investigative Unit (SIU)
- Policy analysis to determine claim coverage, including communicating claim declination to policy holder and agents
- Successfully resolves and negotiates claims with contractors, public adjusters, and the insured
- Responsible for quality, expense management, product delivery, customer service, relationship management, and managing change
- Achieved and met company goals for cycle times and quality results
- ERT (Enterprise Response Team) trained claim professionals outside of property in aspects of building damage claim investigation and Xactimate
- Member of FRT for over ten years, responsible for immediate travel anywhere in the U.S. in response to CAT events
- Handled claims in multiple states, and adhered to state policies, endorsements, laws and correct management procedures for that state and service center
- Achieved the handling of over 40 plus claims during CAT tours
- Re-inspection of claims to provide accurate supplemental payouts
- Accurately scoped, estimated property damage and timely resolution of claims
- Attended major CAT’s such as Katrina, Ike & Sandy in addition responded to various other catastrophes in the U.S.
Education
Empire State College
01.2002
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Erie Community College
01.1988
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Alfred State Collage
01.1987
Skills
- Critical thinking
- Claims investigation
- Active listening
- Highly motivated
- Caseload management
- Report writing
- Policy interpretation
Timeline
Senior Outside Claims Adjuster/Inside
National General Insurance Company/Allstate Corporation
01.2021 - Current
Outside Claims Representative- Independent Adjuster
A.E. Mahoney & Co., Inc.
01.2015 - 01.2021
Outside Claims Representative
The Travelers Insurance Companies, Inc.
01.2002 - 01.2015
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Erie Community College
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Alfred State Collage
Empire State College
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