Marlye Gorostiza

• Reviewed, investigated and managed property casualty claims, to affirm or deny claims process in accurate and timely manner.
• Utilized services of preferred repair firm service providers for assessment of damages.
• Worked with moving companies to obtain inventories and documents, and to trace for missing items.
• Settled claims by working directly with customers.
• Recovered monies from moving companies for claims that had subrogation components.

• Investigated, secured and analyzed information pertaining to claimants’ medical condition, occupational demands, insured status, and other policy provisions to accurately determine eligibility for, and entitlement to Long Term disability benefits.

• Ensure company’s reserve liability is accurately established by identifying all applicable claim offsets , maintaining accurate claim and system data.

• Developed and executed 40 to 50 claims monthly for approval of disability benefits.

• Interviewed claimants to gather factual information

• Investigated, processed and managed over 120 Long Term Disability insurance claims for policyholders.
• Interviewed claimants and witnesses to gather factual information.
• Finalized Short Term and Long Term Disability files for insurance claim payment release.

• Managed company’s work accident hotline for eight states by interviewing employees over phone on work related injuries.
• Process new losses for disability and workers compensation claims with designated carriers and follow up with employees and insurance carriers on all workers compensation pending claims.
• Monitor all lost time and restricted duty claims. Expedite and coordinate return to work process with injured employees.

• Interview potential clients, gather all relevant information, complete applications, and entitlement forms.
• Provide recommendations to attorneys as to whether client had valid potential claim.
• Negotiate settlements and finalize stipulations.
• Engage in conversations with clients, insurance companies and medical providers.